SIGNATURES/AUTHORIZATIONS
I verify the instructions provided do not constitute a transfer for consideration (transfer of stock, funds, or any other assets for payment of goods or
services). If the delivering account has multiple Authorized Agents (including Trustees), and all Authorized Agents are required to sign per the terms
of the governing documents, then all Authorized Agents must sign. If a debit balance is being transferred, all receiving Account Owners/Trustees must
also sign this form to accept the debit.
Unless otherwise indicated, I authorize the Transferor to liquidate any nontransferable proprietary money market fund assets that are part of my
account and to transfer the resulting credit balance to my account with TD Ameritrade. I authorize the Transferor to deduct any outstanding fees due to
Transferor from the credit balance in my account. If my account does not contain a credit balance, or if the credit balance in the account is insucient
to satisfy any outstanding fees, I authorize Transferor to liquidate assets in my account to the extent necessary to satisfy that obligation. If certificates
or other instruments in my account are in your physical possession, I instruct Transferor to transfer them in good deliverable form, including axing
any necessary tax waivers, to enable the successor custodian to transfer them in its name for purpose of sale, when and as directed by me. I
understand that upon receiving a copy of this transfer instruction, Transferor will cancel all open orders for my account.
By my signature below, I certify that the information and instructions provided, and the elections made are true and correct, TD Ameritrade Clearing,
Inc., may justifiably reply upon the instructions and elections made herein and is authorized to deposit the funds or securities in the manner provided
by this Internal Transfer Form. I release and agree to indemnify and hold harmless TD Ameritrade, Inc., and divisions thereof from liability for any
adverse consequences that may result from this transaction. Please sign, print, and mail or fax this form to initiate the transfer request.
Signature of Delivering Account
✗ Owner or Authorized Person: ____________________________________________________________________ Date: ________________________
Printed Name: _____________________________________________________________________________________________________________________
Co-Signature of Delivering
✗ Account Owner or Authorized Person: _____________________________________________________________ Date: ________________________
Printed Name: _____________________________________________________________________________________________________________________
Personal contributions made to an IRA or Roth IRA must be signed by the IRA or Roth IRA account holder. Please also sign for acceptance
of negative balances, short options, and short stock (Non-IRA Accounts only).
Signature of Receiving Account
✗ Owner or Authorized Person: ____________________________________________________________________ Date: ________________________
Printed Name: _____________________________________________________________________________________________________________________
Co-Signature of Receiving
✗ Account Owner or Authorized Person: _____________________________________________________________ Date: ________________________
Printed Name: _____________________________________________________________________________________________________________________
Original signature required; electronic signatures and/or signature fonts are not authorized.
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TDA 490 REV. 03/21
Investment Products: Not FDIC Insured * No Bank Guarantee * May Lose Value
TD Ameritrade Inc. and TD Ameritrade Clearing, Inc., members FINRA/SIPC, subsidiaries of The Charles Schwab Corporation.
TD Ameritrade is a trademark jointly owned by TD Ameritrade IP Company, Inc., and The Toronto-Dominion Bank.
© Charles Schwab & Co., Inc. All rights reserved.
