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*TDAI9017* - TD Ameritrade

Page 1 of 6 TDAI 9017 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: _____ACCOUNT TYPE: PLEASE CHECK THE APPROPRIATE BOXM IndividualM Custodial Account (UGMA/UTMA)1 Under the Laws of (State)2 _____ Age of Termination2 _____ (state of UGMA/UTMA establishment must be provided)M Joint Tenants with Rights of Survivorship If one Joint owner dies, his/her interest passes to the surviving owner(s). (Not available for Louisiana residents)3M Tenants in Common _____% Owner _____% Co-owner If one Joint owner dies, his/her interest passes to his/her estate (50/50, unless otherwise noted).M Community Property For AZ, CA, ID, LA, NM, NV, PR, TX, WA, and WI only.

Page 2 of 6 TDAI 9017 REV. 03/18 Check here if you are a: M | Country of Citizenship (For non-U.S. Citizens and Permanent Residents): U.S. Citizen M Permanent Resident Not a U.S. Citizen If a Permanent Resident, please attach a copy of an unexpired Permanent Resident card.

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