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*TDAI9004* - TD Ameritrade

Page 1 of 6 TDAI 9004 REV. 11/18 account # _____Advisor Code _____Case # _____INVESTMENT ADVISOR: TO BE COMPLETED BY ADVISORI nvestment Advisor Firm (Agent) and Primary Contact:Firm Name: _____Primary Contact: _____COMPLETE ALL INFORMATION BELOW FOR TRUSTT itle of Trust:* _____Effective Date of Trust: _____ Trust Tax ID Number or Social Security Number: _____*If you are unsure of the proper title of your trust, you should consult with your attorney. Some examples of trust titles are: 1) The Smith Family Trust; 2) John Doe (and Mary Doe) Trustee(s) FBO Ann Doe; 3) Mary Brown Trustee under will of Paul Brown. When we open your account , we will include the title, trustee(s), and effective date in the account registration. For example: The Smith Family Trust, John Smith Tr, UA 1/5/76. If you are opening a PENSION OR PROFIT SHARING account , you must use our RETIREMENT TRUST (s): _____PLEASE PROVIDE PRIMARY TRUSTEE INFORMATIONF irst Name: | Middle Initial: | Last Name:Social Security Number: | Date of Birth:Primary Telephone Number: M Check here if this is not a phone number.

Page 1 of 6 TDAI 9004 REV. 03/18 Account # _____ Advisor Code _____ Case # _____ INVESTMENT ADVISOR: TO BE COMPLETED BY ADVISOR

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