STOCK ASSIGNMENT FORM - Aflac

1 TRANSFER SHARES FROM THE FOLLOWING ACCOUNT Print registered owner(s) information as it appears on the statement or STOCK certificate. If deceased, print name(s) and information of the deceased as currently appears on the statement or STOCK certificate. Account Number: Account Name: Address: SSN/Tax ID: Phone Number: TRANSFER INSTRUCTIONS TO EXISTING OR NEW ACCOUNT Aflac Incorporated is a paperless legals agent (PLA) and is DRS-eligible.

2 Please PRINT the name(s), address, and SSN/EIN of the person(s) to whom these shares are to be transferred. Trust registrations must include the name of the trustee(s), the name of the trust, and the date of the trust agreement. Accounts for a minor must name one adult custodian (one custodian and only one minor per account). Provide both the minor and custodian s Social Security number. A joint account will be presumed to be joint tenants with rights of survivorship (JTWRS), unless indicated otherwise. Provide Social Security number(s) for all tenants.

3 ATTACH ALL CERTIFICATES TO BE TRANSFERRED SHARES WILL DEFAULT TO BOOK OR DEPOSITED INTO THE DIVIDEND REINVESTMENT PLAN TRANSFER SHARES TO THE FOLLOWING (Additional STOCK ASSIGNMENT forms required for multiple transfers.) Number of Shares: Account Number: Account Name: Address: SSN/Tax ID: SSN/Tax ID: (If joint or custodial) Phone Number: Cell Number: Number of Shares: Account Number: Account Name: Address: SSN/Tax ID: SSN/Tax ID: (If joint or custodial) Phone Number: Cell Number.

4 Affix MEDALLION SIGNATURE GUARANTEE below LEGAL SHAREHOLDER SIGNATURE(S) IMPORTANT Transfer request will be rejected IF STOCK ASSIGNMENT is not Medallion Guaranteed (unless signer is surviving joint tenant or minor of age and is, removing deceased or custodian names only). All owners MUST sign. If signer is NOT the owner, he or she MUST STATE THE CAPACITY. Example: Custodian, Executor, Administrator, Trustee, Guardian X_____ Signature of Registered Owner If Agent/Executor, STATE CAPACITY TO ACT. Date X_____ Signature of Registered Owner If Agent/Executor, STATE CAPACITY TO ACT.

5 Date X_____ Signature of Registered Owner If Agent/Executor, STATE CAPACITY TO ACT. Date IMPORTANT READ CAREFULLY: The signature of the person executing this power must be guaranteed by an Eligible Guarantor Institution such as a Commercial Bank or Securities Broker/Dealer participating in the Medallion Program pursuant to SEC Rule 17 Ad-15. NOTARIZED SIGNATURES ARE NOT ACCEPTABLE. Most major banks will provide this service. Be aware that each financial institution s Medallion Signature Guarantee contains a maximum dollar value that it covers.

6 The Medallion Signature Guarantee must be sufficient to cover the value of shares being transferred. Additional information on this can be obtained from your financial institution. STOCK ASSIGNMENT form Mail to: Aflac Incorporated Attn: Shareholder Services 1932 Wynnton Rd. Columbus GA 31999 Questions? Call: Email.