Fillable Payroll Direct Deposit (TD Ameritrade)

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Payroll Direct Deposit (TD Ameritrade)

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ES_TDR_PD_081901 1119— Page 1 of 2
DO NOT STAPLE
1
TD Ameritrade 529 College Savings Plan
Payroll Direct Deposit
• Use this form to start, change, or stop payroll direct deposit instructions on your
existing TD Ameritrade 529 College Savings Plan Account(s). You may also provide
your payroll direct deposit instructions when you log on to our website at www.
tdameritrade.com/collegesavings. (If you have not established an Account, you
must also complete and enclose an Enrollment Form.)
• After this form is processed, you will receive a Payroll Direct Deposit
Confirmation Form, which you must sign and submit to your employer’s payroll
department. Your payroll direct deposit instructions will not take effect until your
employer has accepted your signed form.
• Type in your information and print out the completed form, or print clearly, preferably
in capital letters and black ink. Mail the form to the address listed. Do not staple.
Forms can be downloaded from our website at
www.tdameritrade.com/collegesavings
,
or you can call us to order any form — or request assistance in completing this form — at
1.877.408.4644 any business day from 8 a.m. to 8 p.m. Central time.
1.
Account Owner information
Account Number
Name of Account Owner (rst, middle initial, last)
Telephone Number (In case we have a question about your Account.)
2.
Employer information
Name of Employer
Address
City State Zip Code
Payroll Department Contact Name Telephone Number Extension (if any)
TDA52910
1.877.408.4644
8 a.m. to 8 p.m. Central time M-F
www.tdameritrade.com/collegesavings
tdameritrade@NEST529.com
Regular mailing address:
TD Ameritrade 529 College Savings Plan
P.O. Box 30278
Omaha, NE 68103-1378
Overnight mailing address:
TD Ameritrade 529 College Savings Plan
920 Main Street, Suite 900
Kansas City, MO 64105
ES_TDR_PD_081901 1119— Page 2 of 2
DO NOT STAPLE
2
3.
Payroll Direct Deposit instructions
Check one: Start Payroll Direct Deposits Change the Allocation of the Stop Payroll Direct Deposits
Amount Each Account Will Receive (Skip to Section 4)
My payroll direct deposit will be
00
$
, .
each pay period, allocated among my TD Ameritrade 529 College
Savings Plan accounts as described below. If in the future you want to change the amount of your payroll direct deposit, talk to your
employer’s payroll office.
Please use an additional sheet if you have more than four Accounts.
00
$
, .
Account Number Dollar Amount
Name of Beneciary (rst, middle initial, last)
00
$
, .
Account Number Dollar Amount
Name of Beneciary (rst, middle initial, last)
00
$
, .
Account Number Dollar Amount
Name of Beneciary (rst, middle initial, last)
00
$
, .
Account Number Dollar Amount
Name of Beneciary (rst, middle initial, last)
4.
Signature — YOU MUST SIGN BELOW
I certify that I have read and understand, consent, and agree to all the terms and conditions of the TD Ameritrade 529 College Savings
Plan Program Disclosure Statement and Participation Agreement and understand the rules and regulations governing the TD Ameritrade
529 College Savings Plan. Further, I understand that neither the TD Ameritrade 529 College Savings Plan, the Nebraska Educational
Savings Plan Trust, the State of Nebraska, the Nebraska State Treasurer, the Nebraska Investment Council, First National Bank of Omaha,
TD Ameritrade, TD Ameritrade Investment Management, LLC or their agents or afliates are responsible for any claims I may make and/or
losses resulting from my employer’s failure to timely and accurately process my contributions via payroll direct deposit.
SIGNATURE
Signature of Account Owner Date (mm/dd/yyyy)
Securities Products: Not FDIC Insured - No Bank Guarantee - May Lose Value
Nebraska Educational Savings Plan Trust, Issuer. First National Capital Markets, Inc.,
Distributor, Member FINRA, SIPC. TD Ameritrade, Inc., sub-administrator. TD Ameritrade
Investment Management, LLC, portfolio consultant. First National Capital Markets and
First National Bank of Omaha are afliates.
TD Ameritrade, Inc. renders certain marketing and administrative services to the TD
Ameritrade 529 College Savings Plan. TD Ameritrade Investment Management, LLC
renders portfolio consulting services to First National Bank of Omaha and the Nebraska
Investment Council. TD Ameritrade is a trademark jointly owned by TD Ameritrade IP
Company, Inc. and the Toronto-Dominion Bank. All rights reserved. Used with Permission.
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Payroll Direct Deposit (TD Ameritrade)

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Completed 20 September 2020

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