Fillable TRANSFER ON DEATH (TOD) INDIVIDUAL ACCOUNT AGREEMENT CLIENT

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TRANSFER ON DEATH (TOD) INDIVIDUAL ACCOUNT AGREEMENT CLIENT

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Investment products and services are available through U.S. Bancorp Investments, Inc., member FINRA and SIPC,
an investment adviser and a brokerage subsidiary of U.S. Bancorp and affiliate of U.S. Bank.
Not a Deposit Not FDIC Insured Not Guaranteed by the Bank
Not Insured by Any Federal Government Agency May Lose Value
30424D (08/12)
1. Under the title Enter your name, Social Security number, and U.S. Bancorp Investments, Inc. account number.
2. Sec. 1
• Determine how you want your assets inherited at the time of your death.
a) If you want all assets to go only to your spouse:
1) Check #1 and do NOT write anything in Sec. 2 as you have just selected your spouse as your sole Primary
Beneficiary.
2) If you have no spouse at the time of your death: Your assets will go to your estate. There are no Contingent
Beneficiaries. Do not write anything in Sec. 2.
3) Do not complete Sec. 3 of the form.
b) If you want all assets to go to your spouse as your sole Primary Beneficiary
,
but if you have no surviving spouse
(either through death or legal marital dissolution) at the time of your death, you want your assets to go to your children:
1) Check #2 and enter your children’s information in Sec. 2 as “Contingent Beneficiaries”.
2) Do not write anything in Primary Beneficiaries as you have already designated your spouse as your sole Primary
Beneficiary by checking #2.
3) Do not complete Sec. 3 of the form.
c) If you want to name all Primary Beneficiaries and all Contingent Beneficiaries:
1) Check #3 and complete all of Sec. 2.
2) If you are currently married: You must also answer both questions in Sec. 3 on the form.
3. Sec. 2
NOTE: “Rights of representation” was formerly known as “per stirpes”. This is a legal term that means “follows the blood” and
allows for a deceased beneficiary’s children (both biological and legally adopted) to inherit that beneficiary’s share of the
assets as descendants.
• If checking #2 or #3 in Sec. 1: Enter the full legal name of each beneficiary, the Social Security number if you know it (it’s
not required), and the percentage of the account assets you want this beneficiary to inherit.
•
If
you want that beneficiary’s children to inherit his/her share of the assets should the named beneficiary die before you:
Check the box and also enter the number of children the named beneficiary has as of the date you are completing the form.
4. Sec. 3 Complete
only if
you checked #3 in Sec. 1 on the form
and
are currently married.
• Answer the two questions. If either is answered “Yes”:
a) If you did not list your spouse as the sole Primary Beneficiary in Sec. 2: Your spouse is required to sign and date the
form if in one of the specified states.
5. Sec. 4 Sign and date the form.
TRANSFER ON DEATH (TOD)
INDIVIDUAL ACCOUNT AGREEMENT
CLIENT INSTRUCTIONS
You are strongly advised to read pages two and three of the form
for important information regarding Transfer on Death before
completing page 1 of the form.
#0812216
Email to usbiinvestmentsconnect@usbank.com or mail to Investments Connect, EP-MN-WS4M, 60 Livingston Ave., St. Paul, MN 55107.
Check here if wanting Rights of Representation and write number of children born to or legally adopted by this person:
I acknowledge that I have received a full and reasonable disclosure of my spouse’s
property and financial obligations and that I have been advised to seek tax or legal
advice prior to signing this consent to the beneficiary designation above.
TRANSFER ON DEATH (TOD)
INDIVIDUAL ACCOUNT AGREEMENT
Please see pages 2 and 3 of this document for important information
regarding Transfer on Death before completing page 1 of the form.
30424D (09/12)
1. INSTRUCTIONS. Upon death of Account Owner, assets in this TOD account will transfer to the following:
1. To my spouse at the time of my death as my sole primary beneficiary. If no surviving spouse, assets will go into my estate. Do not complete
Sections 2 or 3.
2. To my spouse at the time of my death, or if no surviving spouse, to my descendants by right of representation. If selecting this option, you must:
1) Write the number of children born to or legally adopted by you as of today:
2) Write the beneficiaries in the CONTINGENT BENEFICIARIES section.
Do not list any Primary Beneficiaries in Sec. 2.
3) Check the box following the percentage.
4) Write the number of children in the rectangular box.
3. To designated beneficiaries named in Sec. 2. If you are married: Must answer both questions in Section 3 of this form.
192
3. COMMUNITY or MARITAL PROPERTY STATE. Complete only if currently married and you selected #3 in Sec. 1 above.
Applicable states: AZ, CA, ID, LA, NV, NM, TX, WA, WI. Must answer both questions.
1. Did your marriage occur in one of these states? Yes No 2. Do you currently reside in one of these states? Yes No
If answering "yes" to either question: Your spouse must be your sole primary beneficiary or consent to your beneficiary designation. If
you selected option 3 above and your spouse is not listed as the sole primary beneficiary, your spouse must sign here or the TOD request
cannot be honored.
Date
Signature of Spouse
4. ACKNOWLEDGMENT and SIGNATURE. This form cannot be signed by a fiduciary; e.g., POA or other agent.
Date
Signature of account owner
I have received a copy of this account agreement and the U.S. Bancorp Investments Transfer on Death Disclosure Statement.
2. DESCENDANTS AND/OR DESIGNATED BENEFICIARIES. Attach additional sheet if necesary.
PRIMARY BENEFICIARIES If beneficiary is your spouse, check the box in "Spousal?" column.
FULL LEGAL NAME
%
%
1.
CONTINGENT BENEFICIARIES If beneficiary is your spouse, check the box in "Spousal?" column.
Check here if wanting Rights of Representation and write number of children born to or legally adopted by this person:
%
2.
Check here if wanting Rights of Representation and write number of children born to or legally adopted by this person:
%
3.
Check here if wanting Rights of Representation and write number of children born to or legally adopted by this person:
%
4.
Check here if wanting Rights of Representation and write number of children born to or legally adopted by this person:
%
%
1.
Check here if wanting Rights of Representation and write number of children born to or legally adopted by this person:
%
2.
Check here if wanting Rights of Representation and write number of children born to or legally adopted by this person:
%
3.
Page 1 of 3
SPOUSAL?
SPOUSAL?
FULL LEGAL NAME
SSN/TIN
Optional
SSN/TIN
Optional
Call 1.800.888.4700 for assistance completing this form.
SOCIAL SECURITY NUMBER ACCOUNT NUMBERPRINT NAME OF ACCOUNT OWNER
CONTACT
PHONE # WHERE YOU CAN BE REACHED.
10 digits.
30424D (09/12)Page 2 of 3
To: U.S. Bancorp Investments, Inc.
In consideration of your opening and continuing a U.S. Bancorp Investments, Inc. TOD Security Account for me, I ("I", "me", or "customer"
means the individual signing this Agreement at the customer signature line. "You" and "Your" means U.S. Bancorp Investments, Inc.) agree as
follows:
1. Establishment of Transfer on Death Account. I desire to establish a Transfer on Death (TOD) Security Account pursuant to the
provisions of the Minnesota Uniform TOD Security Registration Act (Minnesota Statutes, Sections 524.6-301 to 524.6-311). Upon my
death, you will transfer the assets in my TOD Account which are eligible for TOD distribution, according to the terms and conditions of this
Agreement, to the beneficiaries and in the proportions designated in this Agreement.
2. Governing Law. This Agreement shall be governed by the laws of the State of Minnesota and shall inure to the benefit of
U.S. Bancorp Investments and its successors and assigns and shall be binding on me, my heirs, executors, administrators, assigns, and
beneficiaries.
3. U.S. Bancorp Investments, Inc., TOD Disclosure Statement to Apply. I understand that this TOD Account Agreement shall be subject
to the U.S. Bancorp Investments TOD Disclosure Statement, a copy of which I have received, and the provisions of the Minnesota Uniform
TOD Security Registration Act. I understand that the terms defined in the U.S. Bancorp Investments TOD Disclosure Statement shall have
the same meaning in this Agreement. I further understand that the U.S. Bancorp Investments TOD Disclosure Statement may be amended
by U.S. Bancorp Investments at any time upon thirty (30) days notice mailed to me at my address of record at U.S. Bancorp Investments.
4. Effect of Other State Laws. I acknowledge and agree that if Transfer on Death Registration is not permitted under the laws of the
jurisdiction where I am domiciled at the time of establishing the TOD Account or at the time of my death, you may, absent notice from any
duly appointed executor or administrator of my estate or any person having or claiming to have an interest in my estate or any claim to the
Eligible Securities in my TOD Account on behalf of my estate, transfer the Eligible Securities pursuant to the beneficiary designations set
forth. I agree that you shall have all the protections of the Minnesota Uniform TOD Security Registration Act in the event of any such
transfer and I, on behalf of my estate and my successors in interest, further agree to indemnify and hold you harmless from any claims
against my estate or any person acting on behalf of my estate for any such transfer.
5. Allocation of Account Assets
• If the TOD Account Agreement designates percentages that equal more than one hundred percent (100%), the share of each beneficiary
shall be reduced proportionately until the total equals 100%.
• If the TOD Account Agreement designates percentages that equal less than 100%, the share of each beneficiary shall be increased
proportionately until the total equals 100%.
6. Changes of Beneficiaries. I acknowledge and agree that this Agreement shall not be effective until it is received and accepted at your
principal office. I understand that any changes in the Designated Beneficiaries or the Contingent Beneficiaries may be made only by
completing a new U.S. Bancorp Investments Transfer on Death Account Agreement signed by me and that no such change shall be
effective until it is received and accepted by you at your principal office. I understand that, pursuant to Minnesota statutes governing this
TOD Account, I may revoke all designations of Beneficiaries by specific reference to this TOD Account in my Will.
7. Right to Change Beneficiaries. I understand and acknowledge that no agent, attorney-in-fact, conservator, guardian, or other person
acting in my behalf may change the Beneficiaries except by Court Order. This provision shall not prohibit the sale, pledge, or other transfer
of the securities in my TOD Account by any agent, attorney-in-fact, conservator, or guardian.
8. Distribution to Descendants by Right of Representation. Assets distributable to the descendants of a deceased person "by right of
representation" shall first be divided into as many shares as there are surviving children and deceased children of the deceased person.
Each surviving child shall receive one share and the share of each deceased child will be distributed to that child’s descendants,
proceeding through each generation until surviving issue exists.
"Issue" is defined as any child born to or legally adopted by the person.
Example: Generation 1 = Albert, age 86, and his wife Alice were original JTWROS owners of this TOD Account.
After Alice passed away, Albert became sole owner with the same TOD in effect as previously.
Albert and Alice were the parents of Barbara and Burton.
Generation 2 = Burton, age 58, father of Chaz and Chase
Barbara, age 54, Burton’s sister who has no children
Generation 3 = Chaz, age 28, and Chase, age 26; Burton’s sons
Generation 4 = Dustin and Derek, age 1; Chaz’s twin sons
Scenario: 1. Burton and his son Chaz are killed in the same accident.
2. Burton’s dad Albert dies two years later. Since Albert had two children, two equal shares are created: 50% for
Barbara and 50% for Burton’s issue.
3. Because Burton is deceased, his share passes down one generation to his two sons Chaz + Chase "by right of
representation."
• Chase inherits 50% of Burton’s share. (This equals 25% of Albert + Alice’s assets.)
• Because Chaz is deceased, his share passes down one generation to his little boys "by right of
representation." (This equals 12.5% of Albert and Alice’s assets to each little boy.)
TRANSFER ON DEATH INDIVIDUAL ACCOUNT AGREEMENT
ACCOUNT #NAME SSN/TIN
192
30424D (09/12)Page 3 of 3
12. Designated Beneficiaries
A. PRIMARY BENEFICIARIES
• The assets subject to this beneficiary designation shall be allocated among the Primary Beneficiaries who survive the Account
Owner in the percentages specified.
• If a Primary Beneficiary does not survive the Account Owner, one of three scenarios will apply:
1. That Primary Beneficiary’s share shall be distributed to that Primary Beneficiary’s descendants by right of representation if that
option has been selected on page 1.
OR
2. If that option has not been selected:
That Primary Beneficiary’s share shall be allocated proportionately among the surviving Primary Beneficiaries (or their respective
descendants by right of representation, if applicable and so indicated on page 1.)
OR
3. a. If no Primary Beneficiary survives (and no descendant survives any Primary Beneficiary to engage rights of representation if
so indicated on page 1): Account assets will transfer to listed Contingent Beneficiaries in the percentages specified.
b. If no Contingent Beneficiary is listed or if none of the Contingent Beneficiaries (or descendants if applicable and selected on
page 1) survives the Account Owner: Account assets will transfer to the Account Owner’s estate.
B. CONTINGENT BENEFICIARIES
• If no Primary Beneficiary survives the Account Owner and if a Contingent Beneficiary does not survive the Account Owner, one of
the following scenarios will apply:
1. That Contingent Beneficiary’s share shall be distributed to that Contingent Beneficiary’s descendants by rights of representation
if that option has been selected on page 1.
OR
2. If that option has not been selected: That Contingent Beneficiary’s share shall be allocated proportionately among the surviving
Contingent Beneficiaries (or their respective descendants by right of representation, if applicable and so indicated on page 1).
OR
3. If none of the Contingent Beneficiaries (nor any of their respective descendants, if applicable) survives the Account Owner:
Account assets shall be distributed to the Account Owner’s estate.
9. Beneficiary Designations Not Subject to Probate Rules. TOD accounts may not be subject to the laws of probate in my state of
residence. I have been advised to seek legal counsel regarding provisions of Transfer on Death Accounts as they apply in my state.
10. Other Agreements Not Revoked. This TOD Account Agreement shall be subject to the terms of all other Agreement which I have
executed with regard to this TOD Account.
11. Account Fees. The annual fee, if any, will be charged on an annual basis as determined by U.S. Bancorp Investments. Any fees owed to
U.S. Bancorp Investments and remaining unpaid, shall be deducted from the TOD Account or paid from the proceeds of the sale of
Eligible Securities in the TOD Account as selected by U.S. Bancorp Investments prior to transfer.
ACCOUNT #NAME SSN/TIN
192
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Completed 30 June 2021

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