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BENEFICIARY DESIGNATION FORM FOR …

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BENEFICIARY DESIGNATION form FOR qualified ACCOUNTSACCOUNT INFORMATIONAccount Title: ________________________________________ ________________________________________ ____________________I hereby make the following DESIGNATION of BENEFICIARY pursuant to the provisions of the TD Ameritrade qualified plan document. In the event of my death, pay any interest I may have under said account in proportions as indicated to the following primary BENEFICIARY or beneficiaries. Unless otherwise noted, proportions are deemed to be in equal percentages and cannot be expressed in dollar amounts. If a trust is designated as a BENEFICIARY , then the trust title and UA date must be provided.

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