Page 1 of 2 TDA 2333 F 04/21
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*TDA2333*
Return Options:
Electronically via Message Center:
Log in and go to Client Services >
Message Center to attach the le
Regular Mail:
PO Box 0, Omaha, NE 10-0
Overnight Mail:
00 South 10th Avenue
Omaha, NE 1-1
Fax: --
Name Change
Authorization
Account Owner Information
List all Account Number(s) to be modied:
Please select a reason below for the name change, and then follow the instructions for additional documentation.
CC
Marriage — Enclose a copy of the marriage certicate and complete Sections 1 and . If you are unable to provide a copy of the marriage certicate,
complete only Sections 1 and . Please provide a copy of a drivers license or Social Security card with the new name.
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Divorce — Enclose a copy of the divorce decree and complete Sections 1 and . Divorce decree must state the name change.
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Naturalization — Complete Sections 1 and . Enclose a copy of the naturalization document clearly displaying former and new name. If the
document does not reect both names, please also provide a copy of a birth certicate or passport with the former name.
CC
Other — Please follow the instructions below, depending on the appropriate circumstances.
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Ocial name change by court decree — Enclose a certied court decree of the name change and complete Sections 1 and .
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Ocial name change by adoption — Enclose a certied 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:
Middle Name:
Middle Name:
Last Name:
Last 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:
CC
Check here if you have Visa® or check-writing privileges on the account(s) listed above.
Primary Phone number:
Email Address:
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Authorization
Signature Verication
Original
signatures
are required;
electronic
signatures
and/or
signature
fonts are not
authorized
Original
signatures
are required;
electronic
signatures
and/or
signature
fonts are not
authorized
X
X
Signature of New Name:
Signature of New Name:
Date:
Date:
Sign Here
Sign Here
I hereby authorize TD Ameritrade to change my name on the account(s) listed above as provided by the enclosed supporting
documentation and/or this completed form.
Only complete this section if you are submitting a name change due to marriage and are unable to attach a copy of the
marriage certificate.
STOP HERE PLEASE! This document must be signed at the time of obtaining a Notary or TD Ameritrade Branch Stamp.
Notary Stamp or TD Ameritrade Branch Stamp:
Do not sign the signature verication section unless present at a
branch or in front of a notary.
TD Ameritrade, Inc., member FINRA/SIPC, a subsidiary of The Charles Schwab Corporation.
TD Ameritrade is a trademark jointly owned by TD Ameritrade IP Company, Inc. and The Toronto-Dominion Bank.
©01 Charles Schwab & Co. Inc. All rights reserved.
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