585797 (Rev 04 – 12/13) Page 1 of 7
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Transfer on Death Kit
Services to TOD Accounts
Easing Transitions
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585797 (Rev 04 – 12/13) Page 2 of 7
TRANSFER ON DEATH (TOD) AGREEMENT
SECTION 1: OPENING YOUR ACCOUNT
To establish a TOD registration of your account(s) with us, you must complete and submit our TOD application, and
we must accept it. We are not required to accept instructions from any other person, including any attorney-in-fact, to
establish, revoke or change a TOD registration.
You must reside in the United States in order to establish a TOD registration with us. TOD registration is not available
for Louisiana residents. If you reside in or move to Louisiana, we have the right to terminate any TOD registration.
Only accounts owned by individuals are eligible for TOD registration. For joint accounts, we will permit TOD
registration on joint accounts with rights of survivorship (including tenants by the entirety), but not on “tenants in
common” joint accounts.
The following types of assets are not eligible for TOD registration:
Physical securities certificates
Limited partnership interests
Certificated shares of mutual fund companies
Assets held in your name at mutual fund companies
Commodities
Precious metals
Annuities
Life insurance policies
We may designate other types of prohibited assets.
SECTION 2: RELATIONSHIP TO OTHER AGREEMENTS
This TOD Agreement supplements any other agreement(s) relating to your account and will be governed by the laws
of the State of New York. If there are inconsistencies between this TOD Agreement and other agreement(s)
governing your account, the terms of this TOD Agreement will apply for issues involving your TOD account.
SECTION 3: REVOCATION
To revoke your TOD registration, you (and any other account owners) must complete our revocation form. We will not
accept a revocation through any other document or through any other person, including any attorney-in-fact.
Revocation will not be effective until we accept the revocation form.
In the case of a joint account, after the death of an account owner, this Agreement shall continue to apply to an
account that must be established by the surviving owner or owners unless the surviving owner or owners change or
revoke this agreement by completing our revocation form. Revocation is not effective until our acceptance of the
revocation form.
SECTION 4: BENEFICIARIES – GENERAL INFORMATION
You may establish a TOD naming one or more beneficiaries who do or do not reside in the U.S. If a client's TOD
beneficiary resides in a country where Wells Fargo Advisors is not authorized to conduct business, then Wells Fargo
Advisors cannot provide ongoing financial services to the beneficiary and will only permit the beneficiary to open an
account on a temporary basis in order to facilitate distribution of the TOD. Please note, however, that Wells Fargo
Advisors will not accept any TOD beneficiary designation where a beneficiary resides in a country that is subject to
U.S. Department of Treasury Office of Foreign Asset Control (“OFAC”) sanctions. We are not required to accept
instructions from any other person, including any attorney-in-fact, to name or change beneficiaries.
You must provide the name, address, birthdate, and taxpayer identification number for any beneficiary.
If you designate a trust as a beneficiary, you must specify the date the trust was established. For any trustee you
name, your designation includes any co-trustee or successor trustee. If any trust or entity is revoked or terminated
before the last surviving account owner’s death, we will treat the trust or entity as if it were an individual who died
before the last surviving account owner.
To change a beneficiary, all account owners must complete a new TOD application, and we must accept it.
We will honor only the most recent beneficiary designations on file with us.
Your beneficiary designations will not be subject to state probate rules. We will not honor “per stirpes” or any similar
designation where we would have to determine the identities of heirs of a deceased beneficiary.
A beneficiary has no rights in your account until all account owners have died. From the last surviving account
owner’s death until the distribution of assets, all living beneficiaries will be tenants in common.
585797 (Rev 04 – 12/13) Page 3 of 7
SECTION 5: PRIMARY BENEFICIARIES
You must designate one or more primary beneficiaries to whom we will distribute your account assets upon the last
surviving account owner’s death.
You should designate a percentage of assets for each primary beneficiary. If you do not designate percentages, then
all primary beneficiaries will share equally. If you designate percentages and the total is more than 100%, the primary
beneficiaries will share in proportion to their designated percentages. If you designate percentages and the total is
less than 100%, we will distribute the percentage for which no primary beneficiary is designated to the last surviving
account owner’s estate.
SECTION 6: CONTINGENT BENEFICIARIES
You may (but are not required to) designate one or more contingent beneficiaries for your account(s).
A contingent beneficiary will receive a portion of the account assets of a designated primary beneficiary who dies
before the last surviving account owner.
If you do not designate a contingent beneficiary or if the contingent beneficiary designation does not equal 100% for
each designated primary beneficiary, and all primary beneficiaries have died, your assets or a portion of your assets,
will go to the estate of the last surviving account owner.
SECTION 7: MINOR BENEFICIARIES
If a beneficiary is a minor, then you must designate a custodian under the Uniform Transfers to Minors Act (UTMA). If
you have not nominated a custodian for a minor beneficiary, or if the custodian is unable or unwilling to accept the
distribution, we may distribute your assets to an UTMA custodian who is later appointed for the minor, or to the
minor’s conservator or guardian. Custodians under the Uniform Gifts to Minors Act (UGMA) are not eligible to be
beneficiaries or receive distributions.
SECTION 8: DISTRIBUTIONS
After the last surviving account owner dies, we will not permit any activity in your account until the requirements below
are met.
Before distributing assets, we must receive the following:
a. Legal proof of death of all account owners;
b. A copy of our distribution request form, signed by or for each beneficiary or personal representative of the last
surviving owner’s estate;
c. A waiver of inheritance or estate taxes (if required under state law).
If a beneficiary is an estate, then we will require (1) letters testamentary for the personal representative(s), and (2) an
affidavit of domicile. If a primary beneficiary dies before the last surviving account owner, we will require legal proof of
death.
Once we approve these documents, we will distribute your assets in kind to the beneficiaries according to the
percentages in the most recent TOD agreement on file with us. Assets will not be sold in your account in order to
distribute cash to your beneficiaries. Any residual dividends and interest will be distributed in accordance with the
percentages designated in the most recent TOD agreement on file with us.
If any primary beneficiary dies before the last surviving account owner, we will distribute that beneficiary’s share to (a)
the corresponding contingent beneficiary, (b) the other primary beneficiaries on a pro rata basis, or (c) your estate,
depending on the option you have chosen. If you designate contingent beneficiaries and if any of the contingent
beneficiaries die before the last surviving account owner, we will distribute that share to the last surviving account
owner’s estate. If we cannot determine the order of death of the last surviving account owner or any beneficiary, then
we will assume that the beneficiary died first.
We may reduce or eliminate distributions if we receive written notice from an account owner’s estate that the assets
must be used to pay the estate’s expenses. In such case, the estate’s personal representative may select assets to
distribute to the estate.
When we receive notice of the last surviving account owner’s death, we will have no obligation to:
a. Locate any beneficiary or any account owner’s heirs or representatives of their estates;
b. Notify any person of a proposed or com
pleted transfer of your assets; or
c. Verify any information submitted by a person claiming to have an interest in your account.
585797 (Rev 04 – 12/13) Page 4 of 7
SECTION 9: FRACTIONAL SHARES
Your beneficiaries must instruct us in writing on how to allocate fractional shares or assets subject to minimum share
or amount designations. If your beneficiaries do not provide such instructions, we may, but are not required to, sell all
fractional or other shares and distribute the proceeds (after deducting sales commissions and expenses) according to
the percentage for each beneficiary. If we sell any fractional shares or other assets in your account after your death,
the proceeds will be subject to backup tax withholding.
SECTION 10: MARGIN OR DEBIT BALANCE
We have the right to reduce any distribution to beneficiaries if there are any outstanding financial obligations of the
account owner, including but not limited to, any margin or debt balance. This shall include any dividends, interest,
earnings or other payments associated with these account assets. We also have the right to select which assets to
sell to pay the margin or debit balance prior to distribution.
SECTION 11: WELLS FARGO LOAN BALANCE
If your account is pledged to secure a loan balance owed to Wells Fargo Bank, NA when the last surviving account
owner dies, the outstanding loan balance must be paid in full prior to any distributions. We may, at our sole discretion,
sell any and all securities in your account to satisfy any outstanding balance and your representatives or beneficiaries
will not be entitled to choose which securities are sold. If the last surviving account owner is deceased, contact
collateralmanager@wellsfargo.com for instruction on paying off the outstanding loan balance.
SECTION 12: LIABILITY
We will not have any liability if we pay out interest or dividends after the last surviving account owner’s death and the
beneficiaries have not provided us with all of the documents listed in Section 8 above in a timely manner.
Should our distribution of assets be delayed by the beneficiaries’ failure to provide us with the documents listed in
Section 8 above, or by a dispute or claim to your account, we will not be liable for any resulting decline in the value of
your account.
Once we distribute assets from your account, we will be released fully from any liability.
If we distribute assets to a beneficiary and a court finds that the beneficiary is liable to an account owner’s estate for
expenses, then we will have no liability to the estate or to the beneficiary, unless we received written notice of
objection before the asset distribution.
We will not be liable for failing to notify you of changes in TOD law that may affect your account.
SECTION 13: DISPUTES
If we cannot determine the person entitled to receive a distribution or their proper share, or if a dispute by a
beneficiary or a beneficiary's descendants or spouse arises as to the proper distribution, or if claims to the distribution
are made by creditors of the estate, surviving spouse, personal representative or executor, heirs or others, we
reserve the right to require the parties to determine their respective rights by court order, arbitration or in any other
manner acceptable to us prior to making any distribution.
SECTION 14: MISCELLANEOUS
You, your estate or your successors-in-interest, including all beneficiaries and heirs shall fully indemnify and hold
Wells Fargo Advisors, its agents, affiliates, successors and assigns, parent companies, subsidiaries, officers,
directors, shareholders, members, employees and attorneys harmless from and against all claims, actions, costs,
liabilities and damages including attorney fees arising out of or relating to:
Any conflicting designation of the assets in your Account by Will, trust or any other instrument;
Any written change of beneficiary(ies) that you have made that has not been accepted by us;
Distributions made upon notice of the death of the last surviving account holder pursuant to the terms of this
Agreement;
Any other action taken by us in opening and maintaining your account under this Agreement or registering
and titling the securities in your account;
We make no representation as to the effectiveness of your beneficiary designations or the tax consequences of
holding this account or distributing assets from it. You should seek legal or other appropriate counsel regarding all
legal and tax issues related to this TOD agreement and registration.
585797 (Rev 04 – 12/13) Page 5 of 7
TRANSFER ON DEATH (TOD) APPLICATION
Account Owner(s) Name(s) Social Security Number(s)
Account Owner(s) Address(es) City State ZIP Code
You are applying for registration of your account in
beneficiary form thereby assigning ownership of the
account upon your death to the beneficiaries you
designate. You direct us to transfer all TOD-eligible
assets in this account in accordance with this direction
and the terms and conditions of this application.
You certify that you have received, read and agree to
all terms of the Transfer on Death Agreement included
with and made part of this Transfer on Death
Application. All terms of this agreement and application
shall be binding upon your heirs, representatives and
assigns.
IF YOU ARE MARRIED AND LIVE IN A COMMUNITY
PROPERTY JURISDICTION (Alaska,
A
rizona,
California, Idaho, Louisiana, Nevada, New Mexico,
Texas, Washington, Wisconsin, or Puerto Rico; in
Alaska, community property rules may be adopted by
agreement signed by the married couple):
If you designate a primary beneficiary who is not you
r
spouse, your spouse should approve your designation.
If you get married after signing this form, your marriage
may make your beneficiary designation(s) invalid, so
your spouse should consent to your designation.
We may reject your TOD application or refuse to
distribute your account assets to your beneficiary(ies) i
f
we have not received your spouse’s consent to you
r
beneficiary designations.
Account Number
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Sub Firm # Account Number
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585797 (Rev 04 – 12/13) Page 6 of 7
Account Number
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Client to com
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TRANSFER ON DEATH (TOD) APPLICATION
PRIMARY BENEFICIARY DESIGNATION
When the last surviving account owner has died and we have received the documents listed in Section 8 of the TOD agreement,
we will transfer assets to the following beneficiaries, if they survive the last account owner. If you indicate no percentages below,
we will divide the assets in your account equally among the beneficiaries. If you designate percentages, they must add up to 100%.
If no primary or contingent beneficiaries are alive when the last surviving account owner dies, or if all beneficiaries disclaim their
interests in your account, we will distribute the assets to the last surviving account owner’s estate. Note: If you designate any
beneficiaries that are minors, you MUST designate a Custodian under the Uniform Transfers to Minors Act (UTMA.) (For example,
list the custodian's name and indicate “as custodian for” and then list the minor's name.)
YOU MUST CHECK ONE BOX BELOW
If any primary beneficiary is not alive when the last surviving account owner dies or if that beneficiary disclaims his/her interest,
then we will distribute that beneficiary’s share as follows:
To the remaining primary beneficiary(ies) on a pro rata basis (proportionate to the designated percentages).
To the applicable contingent beneficiary(ies) designated at the bottom of this page.
To the last surviving account owner’s estate.
(Please use a separate sheet if additional beneficiaries are desired. The sheet must be signed by all account owners.)
1
Relationship to Client Beneficiary Name Soc. Sec. # or Tax ID # Telephone Number
Percentage Beneficiary Address (Street number, City, State and Zip Code) Birth Date or Trust Date
%
2
Relationship to Client Beneficiary Name Soc. Sec. # or Tax ID # Telephone Number
Percentage Beneficiary Address (Street number, City, State and Zip Code) Birth Date or Trust Date
%
3
Relationship to Client Beneficiary Name Soc. Sec. # or Tax ID # Telephone Number
Percentage Beneficiary Address (Street number, City, State and Zip Code) Birth Date or Trust Date
%
4
Relationship to Client Beneficiary Name Soc. Sec. # or Tax ID # Telephone Number
Percentage Beneficiary Address (Street number, City, State and Zip Code) Birth Date or Trust Date
%
CONTINGENT BENEFICIARY DESIGNATION
(Please use a separate sheet if additional beneficiaries are desired. The sheet must be signed by all account owners.)
1
Contingent Beneficiary Name Soc. Sec. # or Tax ID # Telephone Number
Contingent to Primary
Beneficiary Number(s)
Percentage of Primary
Beneficiary Share
Contingent Beneficiary Address (Street number, City, State and Zip Code) Birth Date or Trust Date
%
2
Contingent Beneficiary Name Soc. Sec. # or Tax ID # Telephone Number
Contingent to Primary
Beneficiary Number(s)
Percentage of Primary
Beneficiary Share
Contingent Beneficiary Address (Street number, City, State and Zip Code) Birth Date or Trust Date
%
3
Contingent Beneficiary Name Soc. Sec. # or Tax ID # Telephone Number
Contingent to Primary
Beneficiary Number(s)
Percentage of Primary
Beneficiary Share
Contingent Beneficiary Address (Street number, City, State and Zip Code) Birth Date or Trust Date
%
4
Contingent Beneficiary Name Soc. Sec. # or Tax ID # Telephone Number
Contingent to Primary
Beneficiary Number(s)
Percentage of Primary
Beneficiary Share
Contingent Beneficiary Address (Street number, City, State and Zip Code) Birth Date or Trust Date
%
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585797 (Rev 04 – 12/13) Page 7 of 7
ACCOUNT INFORMATION (Check one box below.)
Original TOD application
Change of beneficiaries in TOD application
IMPORTANT: If some securities in your account are not eligible for TOD registration, then we will distribute those
securities to the last surviving account owner’s estate. Louisiana residents may not open TOD accounts with us.
Because of the complex legal and tax issues, we cannot advise whether a TOD registration is appropriate for your tax
and estate planning. YOU SHOULD CONSULT WITH YOUR LEGAL AND TAX ADVISORS BEFORE ELECTING OR
REVOKING A TOD ACCOUNT REGISTRATION.
Account Owner Signature Date
Account Owner Signature Date
SPOUSAL CONSENT
If you live in a community property jurisdiction and your spouse is neither a joint owner nor the sole primary
beneficiary of your account, your spouse should complete this section. By signing below, your spouse declares that
he/she is your spouse and consents to any designation of beneficiaries you have made. He/she agrees not to make
any claim against us or the beneficiary(ies) as a result of any distribution we make.
Name of Spouse (Please type or print)
Address of Spouse City State ZIP Code
Signature of Spouse Date
REQUIRED NOTARIZATION OF SPOUSE’S SIGNATURE
State Subscribed and sworn to before me
County This Day of the Year
(Signature of Notary Public)
My Commission Expires
WellsTrade
®
- Submit your completed form to:
Wells Fargo Advisors, Attention: H0004-014, PO Box 66535, St. Louis, MO 63166-9954, or Fax to 800-433-0738
Should you require assistance with this form, please call 1-800-TRADERS (1-800-872-3377)
Investments and Insurance Products:
Not Insured by FDIC or any Federal Government Agency May Lose Value Not a Deposit of or Guaranteed by a Bank or Any Bank Affiliate
Wells Fargo Advisors, LLC is a registered broker-dealer and separate non-bank affiliate of Wells Fargo & Company.
Account Number
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Client to com
p
lete-Re
uired
Sub Firm # Account Number
(Office Use Only)
X
X
X
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