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FAX, MAIL, UPLOAD
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Fax
Mail
Subject Line: Operations
Fax Number: 866-699-2969
Ally Bank
PO Box 951
Horsham, PA 19044
Return this form with any attached documents to us in your Secure Messages.
Once you log in, choose Email / Bank Accounts / Send a New Secure Message.
1
Ally Bank Member FDIC
QUESTIONS? CALL 1-877-247-2559 OR VISIT ALLY.COM
UPDATED 08/2019
Add Trustee(s)
To help the United States government ght terrorism and money laundering, federal law requires us to obtain, verify, and record information that identies
each person who opens an account. What this means for you: when you open an account, we will ask for your name, a street address, date of birth, and
an identication number, such as a Social Security number. We may also ask to see your driver’s license or other identifying documents that will allow us
to identify you.
In addition to this form, attach any supporting documentation verifying that the individual/entity below is a Trustee for the Trust titled account(s) listed
above, such as an amendment, letter of appointment, or court order. For additional Trustees, copy this form and submit for each Trustee.
You authorize us to contact you by using any telephone number you provide to us, including a mobile or cell phone number that you are authorized to
use. In addition to manual calling, we may use text messages, prerecorded or articial voice messages, or automatic dialing systems. We will not charge
you for any contact, but your mobile phone service provider may.
If you have a freeze on your credit as a feature of credit security monitoring, we may contact you to lift the freeze temporarily to verify your identity.
We only open accounts for legal U.S. residents. By signing and submitting this application, you are acknowledging that you are a U.S. citizen or resident
alien of the U.S.
I am an existing Ally Bank account owner and would like to use my information already on le.
(Complete only Name, Social Security Number, and Date of Birth information below.)
FIRST NAME M.I. LAST NAME / SUFFIX SOCIAL SECURITY NUMBER
DATE OF BIRTH
EMAIL ADDRESS HOME PHONE
BUSINESS PHONE (OPTIONAL) MOBILE PHONE (OPTIONAL)
RESIDENTIAL STREET ADDRESS (NO PO BOXES) MAILING STREET ADDRESS (IF DIFFERENT THAN RESIDENTIAL)
RESIDENTIAL ADDRESS LINE 2 (OPTIONAL)
RESIDENTIAL CITY MAILING CITYSTATE STATE
ZIP
ZIP
MAILING ADDRESS LINE 2 (OPTIONAL)
Use this form to:
Add or remove a Trustee from a Trust titled account(s), change the Trust title or Trustee name, or modify information on an existing Trust titled account.
NAME OF TRUST (AS IT APPEARS ON THE TRUST AGREEMENT) ACCOUNT NUMBER(S)
Trust Information
STATE ZIPRESIDENTIAL STREET ADDRESS (NO PO BOXES) RESIDENTIAL CITY
Provide a security question with answer and mother’s maiden name that may be used to identify you when contacting us.
SECURITY QUESTION SECURITY ANSWER MOTHER’S MAIDEN NAME
TRUST/TRUSTEE MAINTENANCE REQUEST FORM
Provide a prior residential address if the applicant has been at the above address for less than 5 years. In addition, provide a copy of one of the
following for address verication: Driver’s License, state issued ID card or utility bill (not greater than 60 days).
OCCUPATION EMPLOYER
2
Ally Bank Member FDIC
QUESTIONS? CALL 1-877-247-2559 OR VISIT ALLY.COM
UPDATED 08/2019
TRUST/TRUSTEE MAINTENANCE REQUEST FORM
Remove Trustee(s)
Add Trustee(s) (contintued)
For each Trustee that is being removed, provide his or her name and select the reason for removal. Attach any supporting documentation such as a
death certicate, court order, trust documents or physician notication.
If the title of the Trust has been modied, provide a copy of the Trust Amendment noting the change of title. If the Taxpayer Identication Number
is changing, enter it in the space below.
If a Trustee is changing his or her name, provide a copy of valid identication or formal documentation showing the name change, and provide a copy of
the Trust Amendment (if applicable). Any name changes will take effect on other Ally Bank accounts for which the Trustee is a signer.
A) Is a new Taxpayer Identication Number (SSN/TIN) being used because of the removal of a Trustee?
B) Is a change of address required because of the removal of a Trustee?
FIRST NAME LAST NAME / SUFFIX (JR., SR., III, ETC)
SSN (XXX-XX-XXXX) / TIN (XX-XXXXXXX)
M.I.
Debit Card Requested: Check Order Requested:
Yes
Yes
Yes
Yes No
Yes Yes No
Interest CheckingInterest Checking
Money Market Savings Money Market Savings
No
No
No
No
Death
SSN
Removal Reason:
If Yes, provide the new Taxpayer Identication Number:
If Yes, provide the new address for the Trust below:
Incapacity
TIN
Resignation Other (explain)
RESIDENTIAL STREET ADDRESS (NO PO BOXES)
PRIMARY TRUST CONTACT NAME
MAILING STREET ADDRESS (IF DIFFERENT THAN RESIDENTIAL)
PRIMARY CONTACT PHONE
RESIDENTIAL ADDRESS LINE 2
RESIDENTIAL CITY MAILING CITYSTATE STATEZIP ZIP
MAILING ADDRESS LINE 2
NEW TRUST TITLE
CURRENT TRUSTEE NAME
TAXPAYER IDENTIFICATION NUMBER
NEW TRUSTEE NAME
Trust Title Change
Trustee Name Change
3
Ally Bank Member FDIC
QUESTIONS? CALL 1-877-247-2559 OR VISIT ALLY.COM
UPDATED 08/2019
CERTIFICATION OF TAXPAYER IDENTIFICATION
Account Agreement
By signing below you are giving Ally Bank permission to make the necessary modications to the Trust or Trustees’ information on the account(s) listed
above. If a Trustee is being added to an account and is not a current Ally Bank customer, you authorize us to obtain a consumer report from a consumer
reporting agency to verify information provided in this application or for any legitimate business purpose in connection with the Ally Bank account. For
maintenance requests that involve changes to a Trust name or taxpayer identication number, complete a new signature card to re-certify the Trust
Taxpayer Identication Number and to obtain a new signature.
Acceptance of Terms and Conditions
TRUSTEE SIGNATURE
TRUSTEE SIGNATURE
DATE
DATE
PHONE
PHONE
EMAIL
EMAIL
Certication Of Taxpayer Identication Number
Complete and sign the attached Certication of Taxpayer Identication Number if (1) the primary trustee have been removed from the Trust titled
accounts, (2) the taxpayer identication number has changed on the Trust titled accounts, (3) the Trust name is being changed, or (4) the primary trustee
has changed his/her name.
FORM W9 TAXPAYER IDENTIFICATION NUMBER (TIN) CERTIFICATION (Not applicable for Non-Resident Aliens)
Backup Withholding Instructions
The Internal Revenue Service does not require your consent to any provision of this document other than the certications required to
avoid backup withholding.
You must check off this box if you have been notied by the IRS that you are currently subject to backup withholding
because you have failed to report all interest and dividends on your tax return.
(For individuals, the TIN is your Social Security Number or Individual Tax Identication Number (ITIN) which should match the rst name listed on
the account and will be used for tax reporting purposes. For other entities, it is your Employer Identication Number.)
A.
B. Certication - Under penalties of perjury, I certify that:
1. The number shown on this form is my correct taxpayer identication number (or I am waiting for a number to be issued to me), and
2. I am not subject to backup withholding because (a) I am exempt from backup withholding, or (b) I have not been notied by the Internal
Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has
notied me that I am no longer subject to backup withholding, and
3. I am a U.S. citizen or other U.S. person (including a U.S. Resident Alien), and
4. I am exempt from Foreign Account Tax Compliance Act Reporting.
SOCIAL SECURITY NUMBER OR EMPLOYER IDENTIFICATION NUMBER:
TRUSTEE SIGNATURE NAME OF TRUST DATE
CUSTOMER NUMBER
(INTERNAL USE ONLY)
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Completed 30 July 2020

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