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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

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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