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Internal Transfer Form-TDA 0321 - TD Ameritrade

Page 1 of 3*TDA490*TDA 490 REV. 03/21 Internal Transfer FORMUse to Transfer funds/securities from an existing TD Ameritrade brokerage account to another new or existing TD Ameritrade brokerage account. Not intended for withdrawals from an IRA account. Certain Internal transfers and IRA distributions may be requested on the website, Mail or Fax to:PO Box 2760 Omaha, NE 68103-2760 Fax: 866-468-6268 ACCOUNT INFORMATIONCan be in form of Transfer (between two non-IRA accounts), direct Transfer (between two like titled IRA accounts) or ContributionFROM account number: _____Account title: _____TO account number: _____Account title: _____TRANSFER TYPEP lease select EITHER Full Account Transfer OR Partial Account TransferM Full Account Transfer : Total Transfer of all securities and cash. (No need to list the securities below). M I request to have the delivering account closed after the Internal Transfer Partial Account Transfer : M All Cash M Partial Cash Specify Amount $ _____ M By checking this box I acknowledge the above amount is a negative dollar amount.

by this Internal Transfer Form. I release and agree to indemnify and hold harmless TD Ameritrade, Inc., and divisions thereof from liability for any adverse consequences that may result from this transaction. Please sign, print, and mail or fax this form to initiate the transfer request. Signature of Delivering Account

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