Transcription of FS Form 5511 (Revised February 2 1530-0071 TreasuryDirect ...
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RESET. For official use only: Customer Name Case Number FS form 5511 (revised January 2018) OMB No. 1535-0138. TreasuryDirect transfer Request IMPORTANT: Follow instructions in filling out this form . You should be aware that the making of any false, fictitious, or fraudulent claim or statement to the United States is a crime that is punishable by fine and/or imprisonment. PRINT IN INK OR TYPE ALL INFORMATION. Use this form to request the transfer of securities in a TreasuryDirect account. 1. TreasuryDirect Account Information NOTE: If transferring securities from either a custom, minor, or conversion linked account, show only TreasuryDirect Account Number: the number for the linked account. TreasuryDirect Account Name: Taxpayer Identification Number (SSN or EIN): 2. Description of Securities transfer ALL securities for the above TreasuryDirect account.
FS Form 5511 Department of the Treasury | Bureau of the Fiscal Service 1. FS Form 5511 (Revised February 2021) OMB No. 1530-0071. TreasuryDirect ® Transfer Request. IMPORTANT: Follow instructions in filling out this form. Making any false, fictitious, or fraudulent claim or statement to the United States is a crimeand may be prosecuted.
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