Fillable Trading Authorization Agreement (TD Ameritrade)

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Trading Authorization Agreement (TD Ameritrade)

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File type: PDF

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Page 1 of 4 TDA 073 F 03/21
1
*TDA073*
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
O
v
ernight Mail:
00 South 10th Avenue
Omaha, NE 1-1
Fax: 
--
Trading Authorization
Agreement
Account Information
Account Number: Account Name/Title:
If you want to add an Authorized Agent/Ocer/Partner to the account and not a Full
Trading/Limited Trading Authorization, please submit the Entity Authorized Agent Form
TDA 11, located in the forms library: https://www.tdameritrade.com/form-library.
The Account Owner(s) listed below hereby authorizes and appoints the Authorized Agent(s) below as the Account Owner’s or Owners’
agent(s) and attorney(s)-in-fact for the purchase and sale of securities and other nancial instruments in cash and/or on margin in the
Account Owner’s or Owners’ name or number on the TD Ameritrade Clearing, Inc. (the “Clearing Firm”) books (the “Account”). The
Authorized Agent(s) may act on behalf of and without notice to the Account Owner(s) to buy, sell, sell short, and to otherwise trade
stocks, bonds, mutual funds, options, and/or any other securities, nancial contracts, or nancial instruments. Trading Authorization
does not allow your Authorized Agent to instruct the Brokerage Firm to make any changes to the Account Owner(s) Account, such
as address of record, suitability information, or to upgrade the Account to trade on margin or to trade options. The actions of the
Authorized Agent(s) have the same force and eect as those of the Account Owner(s) with respect to such transactions, and
TD Ameritrade, Inc. (the “Brokerage Firm”) is authorized to follow such actions as if directly instructed by the Account Owner(s). The
Authorized Agent(s) represents they are familiar with the Account Owner(s)' investment objectives, nancial situation, and needs,
and will invest in a manner consistent with these objectives. The Client Agreement set forth in the Account Agreement and all other
agreements applicable to this Account, shall apply equally to the Authorized Agent(s).
If Full Trading Authorization is chosen, this authority includes the right to request delivery of securities or monies from the account in
the Account Owner’s or Owners’ name(s).
If this is a duciary account, the Account Owner(s) arms that this grant of trading authority has been conferred consistent with his/
her duciary duties and powers.
The Account Owner(s) understands all such transactions conducted by the Authorized Agent(s) are at the Account Owner’s or Owners’
own risk. The Account Owner(s) hereby raties and conrms any and all transactions made at any time by the Authorized Agent(s) for
the Account. Accordingly, the Account Owner(s) agrees to indemnify and hold harmless the Brokerage Firm and Clearing Firm from any
and all losses arising from and to promptly pay on demand any debit balance due on the Account. The Brokerage Firm and Clearing Firm
assume no responsibility for trade monitoring or reviewing any investment activity or decision of the Authorized Agent in the Account
Owner(s)' account. Further, the Brokerage Firm or Clearing Firm does not oer legal or tax advice.
This authorization and indemnity is in addition to, and in no way limits or restricts, any rights which the Brokerage Firm or Clearing Firm
may have under any other agreement with the Account Owner(s) or Authorized Agent(s). This authorization and indemnication shall
benet the Brokerage Firm and Clearing Firm, and any successor rms, irrespective of any changes at any time in the personnel thereof,
and their assigns.
This Agreement shall remain in full force and eect until revoked by the Account Owner(s)' written notice addressed to the Brokerage
Firm and delivered to its oces. The Account Owner(s) shall be liable for transactions initiated prior to the Brokerage Firm’s receipt of
such written revocation.
The Authorized Agent(s) agrees to immediately notify the Brokerage Firm in writing if any Authorized Agent(s), or members of his/her
household, are either a) currently employed or licensed by a member of a stock exchange or the Financial Industry Regulatory Authority
(FINRA), or registered as an investment advisor and using the license in a professional sales, trading, or customer service capacity, or b)
a member of the board of directors, 10% shareholder, or policy-making ocer of a company which trades publicly on a stock exchange.
To help the government ght the funding of terrorism and money laundering activities, nancial institutions obtain and record
information in order to ensure the identity of each person authorized to trade on an account.
What this means for you: When you are authorized to trade on an account, we will ask for your name, address, date of birth, and
other information that will allow us to identify you. We may also utilize a third-party information provider for verication purposes
and/or ask for a copy of your driver’s license or other identifying documents.
Reset Form
Page 2 of 4 TDA 073 F 03/21
2
Aliations
CC
Check here if any Authorized Agent is a member of the board of directors, 10% shareholder, or policy-making ocer of a publicly
traded company. Specify the name of the Authorized Agent, the company name, ticker symbol, address, city, and state:
CC
Check here if any Authorized Agent is licensed or employed by a registered broker/dealer, securities exchange, or member of a
securities exchange. We must receive a compliance letter along with this application. Specify the name of the Authorized Agent:
CC
Check here if any Authorized Agent(s) is, or is employed by, a federal or state registered Investment Advisor.
3
Authorized Agent Compensation
CC
Check here if any Authorized Agent is being compensated for providing investment advice, placing trades, or otherwise
managing your account.
Authorized Agent*
Level of Authorization: (check only one). If neither Full nor Limited is marked, the authorization level will default to Limited.
CC
Full Trading Authorization with Privileges to Withdraw Money and/or Securities (Not applicable on IRA, UTMA, UGMA, Estate,
or Trust Accounts; authorization level will default to Limited.)
CC
Limited Trading Authorization for Purchase and Sale of Securities Only
Please specify if you are:
CC
Employed
CC
Unemployed
CC
Retired
CC
Homemaker
CC
Student
CC
Self-Employed
Date of Birth:Relationship to Account Owner: U.S. Social Security Number:**
City:
City:
State:
State:
Zip Code:
Zip Code:
Home Address: (no PO box or mail drop)
Name Prex (optional):
CC
Mr.
CC
Mrs.
CC
Ms.
CC
Dr.
CC
Rev.
Employer Address:
*Signature required below in Section .
**If you do not have a Social Security Number, please submit a photocopy of your passport and a copy of a bank or brokerage statement.
Employer Name (If Self-Employed, provide the name of your business): Occupation/Type of Business:
First Name: Middle Name: Last Name:
4
TD Ameritrade Acct #:
Primary Phone number:
Page 3 of 4 TDA 073 F 03/21
Section 4, Authorized Agent continued
Level of Authorization: (check only one). If neither Full nor Limited is marked, the authorization level will default to Limited.
CC
Full Trading Authorization with Privileges to Withdraw Money and/or Securities (Not applicable on IRA, UTMA, UGMA, Estate,
or Trust Accounts; authorization level will default to Limited.)
CC
Limited Trading Authorization for Purchase and Sale of Securities Only
Please specify if you are:
Date of Birth:Relationship to Account Owner: U.S. Social Security Number:**
City:
City:
State:
State:
Zip Code:
Zip Code:
Home Address: (no PO box or mail drop)
Name Prex (optional):
CC
Mr.
CC
Mrs.
CC
Ms.
CC
Dr.
CC
Rev.
Employer Address:
*Signature required below in Section .
**If you do not have a Social Security Number, please submit a photocopy of your passport and a copy of a bank or brokerage statement.
Employer Name (If Self-Employed, provide the name of your business): Occupation/Type of Business:
First Name:
Middle Name:
Last Name:
Authorized Agent*
TD Ameritrade Acct #:
CC
Employed
CC
Unemployed
CC
Retired
CC
Homemaker
CC
Student
CC
Self-Employed
Primary Phone number:
Page 4 of 4 TDA 073 F 03/21
TD Ameritrade, Inc. and TD Ameritrade Clearing, Inc., members FINRA/SIPC, are subsidiaries 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.
Investment Products: Not FDIC Insured * No Bank Guarantee * May Lose Value
5
Trading Authorization
By our signatures below, the Account Owner(s) and Authorized Agent(s) agree to the provisions within this document in its entirety, and
attest, unless the box below is checked, that this authorization supersedes any prior trading authorization the Account Owner(s) may
have executed with regard to the Account. Furthermore, Account Owner(s) and Authorized Agent(s) acknowledge that the Brokerage
Firm or Clearing Firm may refuse to approve, or remove, the Authorized Agent(s) from acting as the Account Owner(s)' agent on this, or
any other account.
CC
Unless I have checked this box, this form will supersede any prior Trading Authorization Agreements that the Account Owner(s)
may have executed with regard to the account.
All Account Owners and Authorized Agents must sign.
X
X
X
X
Account Owner’s Signature:
Account Agent’s Signature:
Account Co-Owner’s Signature:
Account Agent’s Signature:
Date:
Date:
Date:
Date:
Sign Here
Sign Here
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
Authorized Agent(s)
TD Ameritrade Acct #:
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Trading Authorization Agreement (TD Ameritrade)

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Completed 9 September 2021

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