Page 1 of 2 TDA 2333 F 04/21
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PO Box 0, Omaha, NE 10-0
00 South 10th Avenue
Omaha, NE 1-1
Account Owner Information
List all Account Number(s) to be modied:
Please select a reason below for the name change, and then follow the instructions for additional documentation.
Marriage — Enclose a copy of the marriage certicate and complete Sections 1 and . If you are unable to provide a copy of the marriage certicate,
complete only Sections 1 and . Please provide a copy of a driver’s license or Social Security card with the new name.
Divorce — Enclose a copy of the divorce decree and complete Sections 1 and . Divorce decree must state the name change.
Naturalization — Complete Sections 1 and . Enclose a copy of the naturalization document clearly displaying former and new name. If the
document does not reect both names, please also provide a copy of a birth certicate or passport with the former name.
Other — Please follow the instructions below, depending on the appropriate circumstances.
Ocial name change by court decree — Enclose a certied court decree of the name change and complete Sections 1 and .
Ocial name change by adoption — Enclose a certied decree of the adoption and complete Sections 1 and .
Note: Additional documentation may be required for other types of name changes, as well as a signed Letter of Instruction providing the reason for
the name change.
Former Legal First Name:
New Legal First Name:
Use this form to notify TD Ameritrade that your name has changed due to marriage,
divorce, or other reasons. This form will update your name on your TD Ameritrade
brokerage account(s). If you have any questions, please call us at 800-669-3900.
U.S. Social Security Number:
Check here if you have Visa® or check-writing privileges on the account(s) listed above.
Primary Phone number: