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External Transfer Form - TD Ameritrade

TDA 190 F 03/18 Page 1 of 3 Mail or Fax to: PO Box 2760 Omaha, NE 68103-2760 Fax: 866-468-62681. ACCOUNT INFORMATIONYour TD Ameritrade Account(The registration of the account being transferred should match your TD Ameritrade account and the Tax ID for both the TD Ameritrade account and account being transferred.)Account Number (Required): (Only one per form )Account Registration/Title:Social Security/Tax ID Number:Social Security/Tax ID Number: (Secondary, If applicable)Account Type (select one)N Individual (Non IRA) N Traditional or Rollover IRAN Joint N Roth IRAN Trust N Beneficiary IRAN Corp/Business N Beneficiary Roth IRAN UGMA/UTMA N Qualified Plan (401k, 403B, PSP, etc.)

External Transfer Form Receiving Firm DTC Clearing Number: 0188 Use this form to request the transfer of your existing account to TD Ameritrade. • If you are requesting to transfer from your Qualified Retirement Plan, please contact your plan administrator; this form may not be required.

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