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*TDAI9341* - TD Ameritrade

TDAI 9341 REV. 02/18 Page 1 of 3 INVESTMENT ADVISOR AUTHORITY (REQUIRED)Name of the Advisory Firm you wish to have Move Money authorization on your behalf:TYPE OF REQUESTN New instructions (complete applicable section(s) below and sign)N Replace existing instructions (complete applicable section(s) below and sign)N T erminate ALL authorizations (sign below all existing ACH, Wire, and Internal Transfer Move Money Investment Advisor authorizations on account will be removed)ACCOUNT OWNER INFORMATIONName (First, Middle Initial, Last): | Social Security Number:Primary Telephone Number: | Secondary Telephone Number:Account Number(s) (Multiple accounts may be listed only if they are identically registered): | Account Registration:IRA DISBURSEMENT AUTHORIZATIONIf this account is an IRA, by my signature below on this authorization, I hereby authorize TD Ameritrade to: disburse assets to me at my address of record at the direction of my Advisor and journal assets between my TD Ameritrade accounts of identical registration at the direction of my Advisor as provided in the TD Ameritra

Page 1 of 3 TD 31 21 INVESTMENT ADVISOR AUTHORITY (REQUIRED) Name of the Advisory Firm you wish to have Move Money authorization on your behalf: TYPE OF REQUEST

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