00-66-0891NSB00-66-0891NSB
Incoming Direct Registration System/
Deposit and Withdrawal at Custodian Authorization Letter
Complete
ALL fields
1. Please enter your Merrillaccount information:
Account number: Taxpayer Identification Number
or Social Security number
Use
CAPITAL
Account holder name (first, middle, last) Co-account holder name (first, middle, last)
letters and
BLACK ink.
Account type (select one):
Non-retirement Retirement Street City State ZIP Code
2. Please enter transfer agent’s information:
Complete
only
section 2a
or 2b
2a.
Direct Registration System (DRS): DRS will allow you
to electronically transfer shares from the transfer agent
to Merrill.
Please be sure to include your most recent account
statement, dated within the last six months.
Name of transfer agent
Account number (key)
Stock name Stock symbol
Select one
Transfer Instructions (select one)
transfer
1.
Transfer whole shares. (insert # to be transferred)
option
2. Transfer all whole shares, liquidate fractional shares,
and close the account.
2b.
Deposit/Withdrawal at Custodian (DWAC): A DWAC
typically needs to be done when you are awarded shares from
a company and they are pulled from a pool of shares.
You will not have a personal account with the transfer agent
in these situations.
Name of transfer agent
Control/transaction number (if available)
Titling of your account:
Stock name Stock symbol
Transfer Instructions
1.
Transfer whole shares.
(insert # to be transferred)
3. Sign and date:
Sign and
date
Account holder signature Date Co-account holder signature Date
4. Medallion Signature Guarantee: Only required if transferring from unlike ownership
*Medallion Signature Guarantee is a certification stamp used to protect shareholder accounts and prevent the unauthorized transfer
of assets. By stamping documents, the endorser certifies the signature is genuine and the person signing is legally authorized to do so.
Have
This stamp is available from most banks, credit unions and other financial institutions.
Questions?
Call
Medallion Signature Guarantee Stamp Medallion Signature Guarantee Stamp
877.653.4732
to speak with
a Merrill
specialist
MerrillLynch, Pierce, Fenner & Smith Incorporated (also referred to as “MLPF&S” or “Merrill”) makes available certain investment products sponsored, managed, distributed or provided
by companies that are affiliates of BankofAmerica Corporation (“BofACorp.”). MLPF&S is a registered broker-dealer, Member SIPC and a wholly owned subsidiary of BofACorp.
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