Ameritrade - Cyr Financial

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IRA MOVE MONEY
Ameritrade
ADV!SOR AUTHORIZATION
lnstitutional
DISTRIBUTIONS: TRADITIONAL, ROTH, SEe SIMPLE ONLY
CONTRIBUTIONS: TRADITIONAL AND ROTH ONLY
Account #
Advisor #
Case #
IRA MOVE MONEY IS EXPRESSLY FOR ONLINE ADVISOR AUTHORIW
By enrolling in TD Ameritrade Move Money, you are establishing.a standing authorization to request checks to the address of record, internal
transfers, and/or electronic funding transfers between your TD Ameritrade account and the account at another financial institution specified
below Please note that you must be an account owner on both accounts to enable your Advisor to request transfers from the other account to
your TD Ameritrade account. Not all account types are eligible for Move Money; please contact your Service Team for lnformation. IRA Move
Money is limited to Normal, Premature, Premature w/exception (721), and Disability distributions from traditional, Roth, SEE and SIMPLE
IRA accounts. Any other distribution reason or retirement account types are not eligible for Move Money and will require separate forms. lRA
Move Money automated clearing house (ACH) contributions are limited to traditional and Roth IRA accounts only There are certain types of
distribution instructions that cannot be pre-authorized with this form. An appropriale Distribution Request Form with your signature
will always be required for the following instruction requests:
- Check withdrawal to an address different than the account address of record
- Distributions for a divorce
- Roth conversions
- lRA transfers, rollovers, or in-kind distributions
- IRA recharacterizations
o
o
INVESTMENT
Name of the Advisory Firm you wish to have move money authorization on your behalf
E
New instructions
EI Replace existing instructions
E
Remove ALL authorizations (A!t existing
IRA Move Money lnveslment Advisor Authorizations on account will be removed.)
INFORMATION
Social Security Number:
Name (First, Middle lnitial, Last):
Secondary Telephone Number:
Primary Telephone Number:
AUTHORIZED METHOD(S) OF PAYMENT (SELECT ALL THAT APPLY)
I authorize my lnvestment Advisor to utilize the following methods to disburse funds frorn, or to contribute funds to (ACH and internal transfers
only), my acnount for one-time or recurring cash transactions:
NOTE: THIRD PARTY REQUESTS MAY REOUIRE PHONE VERIFICATION
8
Like Titled lnternal Transfe$ (authoized by Default by signing and submitting this form)
tr Third Party lnternal Transfers
8
(complete section 5)
Checks to the Address of Record (authoized by Default by signing and submitting this form)
E
ACH (Complete section
E
Fed Wires (Comptete section 8)
7)
INTERNAL TRANSFERS- (IF APPLICABLE)
Destination Account Number:
Account Registration:
Amount Registration:
Destination Accounl Number:
Amount Registration:
Account Registration:
'
r
Certain other restrictions apply.
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Page 1 of 4
TDA| 9340 REV 06/14
ACH AUTHORIZATION FOR OTHER ACCOUNT(S)
By signing the Accounr owner Aulhonzation b€low lauthofize TD Amer(rad€ to act upon ihe iflstructions of the lnvestment AdvEor namod above
to (i)inniate.,edn
account(s) or eftoneous or duptacate c.edil or debl enties and to credit or debii the olher account(s) as appropiat€ I agree 10 lorntly and se\€mlly indemnify and hold
TD Amedrrade harmtessfor arry liabilities occufing as a result of TD Ame.itrade r€lying on lhis authorizaiion oraoslructons given puru€ntto il. lacknowledge lhat
these t.ansactions shattbe govemed by the Rut€s of lhe Nationai Automaled Cleanng House Association and otherapplicable tules or regulations, and agree lo abide
by such rutes tag.ee to serite by binding arb(ralion anydispute invotuing TD Ameritrade lhat may arise wilh respeci lo the Move rvloney Service. This adhonzalon will
remain in futtforc; and eflecr untilTD Ameritrade has.ecei!€d not icalion of iis ielmlnalion, such not@ which may be p.ovrded byany oI lhe registercd holde6 ot the
orher accounr(s) al any tim€ by wdting to TD Amedtrade tnsrrtutional (5010 Wai€.idge Vista Orive, San Diego, CA 92121-5775) I acknowledge that fD Ameriirade mlst
receive ihis norilicgrron in a time and manner so asrogive TDAmedlBde and the other inancial institulion(s) a reasonable opponunilylo acl on it.
ACH BANKS OF RECORD (IF APPLICABLE)
Authorize ACH Direclion fse/ectone or both): ETD Ameritrade lo
Selecl one: E Checking E Savings
Bank
E Bank
to TD Ameritrade (Tradilional & Roth only)
ABA lRoulinq) Number
Name on Bank Ac@unl
Bank Ac@unl Number
(erac,
'Please attach voided check.
ADOITIONAL BANK (OPTIONAL)
ALrthorize ACH Direction fse/ect one or both):
Selecl one:
E Checking E
E TD Ameritrade lo
Bank
E Bank
to TD Am€ritrade (Traditional & Roth only)
Savings
ABA (Rodmd Numbe.:
BankCity/Slale:
Bank Acmunt Number:
Name on Bank Accounl la,act)
'Pl€ase attach voided check.
DELIVERY DETAILS
DOMESTIC wlRE INFORMATION
Receiving Bank Name
Bank Ciiy/Slale
Receiving Bank Ac@unl #:
Nama
A
R€csiving Bank Ac@lnt (list name as it appeaB at Bank and it nama @ntains ihtuats. ptease p.oide full nade)
Please provide ihe following inlormation if this requesl is Ior an escrowmortgage or brokerage accounti
For FudherCredirro Name flr nanl€ contalns initials, ptease prcvtde lltlname)
E
Escrow/Modgage
Fib#
E
Brcke6geAccou.t #
OPTIONAL: lntermediary Eank (Please verify this informalon with the receiving bank above if applicable)
lnlermediary Bank ABAJRouiing #
lniemediary Bank Name:
hlemediary Bank Cily/Starer
INTERNATIONAL wlRE INFORMATION (to ensure accuracy. please contacl financial inslitution fot corect routing information)
lnternational wires requests may require disclosure offees. lf we cannot reach you by phone, your lnternational wire requesl may be cancelled.
lntcr..lionrl Aa.k Name
Bank Cily/Country
,laOiriona eant couting totomalion
-
(such as,
So.r
U.K.. IBAN
-
Eurc. T?nsit
-
Canada, C.r'-BE
Pagezd
4
- Me,ico
etc ).
TDA| 9340 REV 06/14
Name
oi
Rsc8iving aank A.cou.t (List n€ne as it appearc
d
aan* ara ir nane
ctnainsiiuas,itees;i;iA;i
.
Re.€iving Bank Accolnt #l
For Furhsr Crcdil Nam€ and
a""ornt
*
PuDos€ of Wire IREOUIREDI Ptoviding a non-specifrc purpose may cause Oatays-tn procassng the wre requesti
r' i
I hereby agGe to ind€mn8 and hold hsrmless TO tune.itade, lnc. irs afiliat€e enO r,ei. ai'oao.s, oni*'sJ-doyeesJnOllears
cGi
6c{bn3, costs, arld lisbilili€s, including aitomey's fs€ arisirE oul of or elat€d b rcliance oo thb authorizstbn and 6 pay pomiuy on d€mand a;y and alt tosses
arisingth€rBfrcm or debit bahnce due ther-n. ln all suci purctEs€s, ssles, or trades you are authorized to tottow the inslruo',:irs of m! egent rn €\€t'concein
mgadtng
my accounl wilh yooi and my Agent is aulho.jzed lo act for ms and on my behalf in th€ sdne ftanner and with the sams tor.€ ana ifed as I mlghio
couh do with
rcsp€d t, such purcrases, sEles, or trades, as wdlwilrr Bsp€ctto all other things n€c€ss€ry or incirental to the fu(heranc€ or condud ol such_purchas8. sate6, or
l6dos, including th€ deli\€ry of monie6 frDm the accounl in th€ Account Owneia{s') name(si to an account in lhe Accoud Owner,s(s,) n".qit. '_ - I hsreby ralify and conlirm any and all tran6aclions.with yo! herelotore or her6aiter mads by my Ag€nt for nry account. This authorizrlion
and indemnity is jn
€ddition to, and in no way limit6 or resticts, any rights thal you mey have und€r any other a6re6m6lnt or agrsements betvr/ssn me and To Ameritla.ts.
This autho zation rs a continuing on€ and shall remain in full io.c€ and effect and you shall ha!€ no duty of inquiry I may changc or rsvoko
this authorization
by a writl€n notjco addlBssed and delivsred to TD Ameritrade. Untjl you receiv€ suitr written rcvocation iyou arb e'ntitteoio aa in relunce on this arJthorizstion
and indernnitylny re,.tlcauon of this aulhorizalion shall hale no etroct on any liability lhat results from Gnsactions iniliated befor€ you recsire w;uen notice
anon and ind€mniry sharr inur6 to rhe benefi of y;ur pres;nr nrrn and of any succ€sso. film or rims, irr;sp.ai". oi i"y
o"
chang€s atany tme rn llt€ p€rsonnel th€roof ,or any c€us€s whatso€v€r, and of the assigns of lour present tirm orany succ€ssor t5rms.
"r'-ee
I hava carrfully rr-ad lhl5 powsr of altornoy attd lndahnity lnd undaBland that ll suirrorizs my agant naftod ho6in to elrrciaa .lghtr and powrrr
ovar
my account a! It I h.d .xorEl!.d th.m my.olt, and that my Ag.rt'3 .ctionr and in3tructlonr x;hh-rE3p.ct to my.c.runt a|! tuflfunalng on mc.
.a-
{Iy:!:!trl::Yth:,t
AE th€ acoount owmr I grani ratjr€m€nl dirtribution end/or conlributbn adhority to th€ tottowing tm€stm€nt A&isor in acconcanc€ with
the el€cii,cnE mad€ on this
iorm. I und€.Eliand tial IRA distributions and contdbulions may have tiax implicsijons- I ecknowt-ectg€ that I am e Bgi6tered account owne, on iqiarret.ccounts
indicated tiDm u/hich I may r€quest t"ansf€rs to my TD Ameritrade account.
Tho authority I am granling to my lnv66lrn€ol Advisor is subjecl lo th€ attached Terms and Condiljons of this ssrvic6 end this A&isor A.rthorizatbn. I
u,|d€rBtand
lhat thas authorizetjon only sllows my Int/estm€nl Advisor to provide Motr'e Money inskuctions b€tw€€n my TD Ameitrade account and ,rry otf,-i i""ornts inoi"afea,
and do6s nol €nablg my lnvestnont dvisor ti, instrucl TD Amerilrad€ to mak6 other typss of disburs€m;nt r€quests at its dirEctioo, partjirtarty tt'ir+pa.ty
raquesls, or !o a€quest additional informauon regtsIding such djsburssments,
By signing b€lo/, I authorize lhe eloctrcnic Lansfer oJ Junds b€lween my ID Amsritrade account and th€ other account{s) spscifed abote
to th€ provisions of this
,dvisor Auhorization and which I aclnowledgs €ceiving and r€viewing, whictr wilt gowrn att trans.ctons inrtist€d und;r'th; Mo1€ Mon€y s€rvic;. I altost that I
am th€ prcg€r paJtv to r€ceilo pavm€n(s) lrom thrs IRA, and I certify lhat all th€ infrrrrBtion p.orid6d on this form is tru€ and accu,Ele, a;d that TD amerit,?d6
shall hat/E no oblilalion torsdfy account ragislretjon irrormatjon. I turth€r ce(iry ihat TD Am;ritlade has not provjded m6 with any tsx aovice, inolrrar art
deciBions €$rding Movs Money lren6Ecliorls aftt my own. I €lpressly assu'n€ h6 r€sponsb rty for sny ad!€r6€ cons€qusoces that msy ,Esutt frcm Mo\re
Mon€y
lrans€ctions, and I indomnily and hold harhl€€s TO Am6rnEde, tnc., iheir dwisions, oiiceE, e;ployees, directo.s, rapr.ienrari,ros, ownirs, arnfiate€, succe$o.s,
and assigm. This authorization ramains in ef6c1 unlil such Ulne lhal TD Amerit'ade receiv€s sr.iitei notification ol its tarminalion.
TD Am€ril,Ed€ Account &vner Signsturei
Dsle:
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TDA| 9340 REV 05/14
MOVE MONEY
PLEASE READ THIS AGREEMENT CAREFULLY ln this Agreement, "1,"'me,"'my," "we,"'us," and "our" refer to the individuals or parties who are the account
owners, have an interest in the account, and consent to be bound by the terms of this Agreement. The following is a legally binding contract between me and
(website), servrces,
of the
llJ Amentrade
Ameritrade websrte
website (websrte),
Ameritrade). This agreement governs my use ol
the TD
services,
TD Ameritrade Institutional, Division of TD Ameritrade, lnc. (TD Amentrade).
and content in relation to funding of my TD Ameritrade account lhrough the use of an Automated Clearing House (ACH) Transaction. Please nole that the ACH
Transaction Client Agreement (Agreement) does not supersede or limit the Terms and Conditions that govern my TD Amerilrade account.
Changes to the Cliont Agre€ment
The policies outlined below are not alFinclusive and may be sublect to change. TD Ameritrade reserves the right to amend, change, and rev,se the Agreement at
any time and without prior notice to me. TD Ameritrade will post such amendments, changes. or modificalions on the website, or at its option, may othemise choose
to deliver to me, eleclronically or otherwise, the amendments, changes, or modifications or the amended Agreement. My continued use of the website and the
Services after the amended Agreement is posted on the website constitutes my agreement to and acceptance of the amended Agreement, regardless of whether
I have actually read the amendments, changes, or modiilcations.
Terms of Usage
I understand that TD Ameritrade provides ACH and wire services for the primary purpose of the purchase or sale of securities.
As applicable, TD Amerilrade may modify the client's electronic bank instructions. From lime lo time, TD Amerilrade, as the originatoi may receive a notification of
change (NOC) from the client's bank. This may occur when previously provided bank instructions have become outdated due to changes with the respective bank
struclure/organization. The Originator is obligated under industry regulation (NACHA 5.3.2) to effect these updates initiated by the client bank (RDFI).
El€ctronic Delivery of lnformation
I understand that TD Ameritrade may electronically deliver to me or my Advisor information about electronic funding, including information about bank setup(s),
status of my deposits or withdrawals request(s), and any other in{ormation necessary to complete my requested transactions.
I understand that "electronically deliver" means that TD Ameritrade may communicate such info to me or my Advisor by email or by posting the in{ormation on the
TD Ameritrade website (where I can read and print the information).
I understand that delivery of information related to my bank setup does not guarantee the acceptance of an ACH transaction by my financial institution.
Right of Revocation
I understand that usage of ACH services to facilitate my recurring transactions may be revoked and discontinued at any time. My Advisor can cancel a recurring
transaction by logging on to the TD Ameritrade Veo€'application and deleting the appropriate transaction. I can cancel a recurring transaction by calling a
TD Ameritrade Client Seruices Representative at 800431-3500 or by writing to TD Ameritrade at:
Mailing Address:
Overnight Address:
TD Ameritrade lnstitutional
TD Ameritrade lnstitutional
PO BOX 919094
5010 wateridge Vista Drive
San Diego, CA 92121-5775
San Diego, CA 92191-9094
I understand that TD Ameritrade must receive my request at least five business days prior to the date the payment is scheduled to be made. I will not be charged
for such cancellation requests.
Electronic Deposit and/or Withdrawal Rejects
I understand that unless my ACH or wire transaction is immediately reJected, TD Ameritrade will post my ACH or wire transaction to my account, subject to
reslriclions. This action is not a confirmation that my financial institution or TD Ameritrade has completed the transfer of funds. I understand that a transfer rejecl
may occul even subsequent to account funding. I will be responsible for any transactions effected in my account based on those funds.
lf TD Ameritrade receives notice that my ACH transaction was not processed as requested, TD Ameritrade may, as a courtesy, atlempt to contact my advisor by
emaal and/or by posting a notice on my account via the website and/or by phone.
Guidelines and Restrictions
I understand the following acceptable deposit guidelines:
A maximum electronic transfer of $250,000 per day must come from a U.S. bank account in U.S. funds.
An ACH transaction may be drawn from a personal checking or savings account titled exactly the same as the TD Ameritrade account to be funded. An ACH
lransaction from a joint bank account may be deposited into eilher bank account holder's TD Ameritrade account.
An ACH transaction from an individual bank account may be deposited into a joint TD Ameritrade account if that party is one of the TD Ameritrade account owners.
An ACH transaction from an individual or joint bank account may be deposited into an IRA belonging to either acmunt owner I undersland that I am responsible for
understanding any tax ramifications related to making a deposit into my lRA.
To complete ao IRA mntribution I must complete an electronic deposit form.
I understand the following restrictions:
TD Ameritrade currently imposes no transaction charges in connection with my use of ACH or wire transfers. TO Ameritrade does, however, charge a fee on direct
deposit and electronic funds transrer items that are returned to TD Ameritrade due to insufficient or uncollected funds in my account at my financial institution. The
fee will be the same as that charged for returned checks as provided in my TD Ameritrade account agreement. TD Ameritrade reser\r'es the right to charge a fee for
this service. Prior to implementing such a fee, TD Ameritrade will communicate any transaction fee(s) that may apply.
The IRS has specific regulations with regard to maximum allowable contributions within each tax year for qualified plans. TD Ameritrade does not give legal or tax
advice, and it is my responsibility to contact a tax advisor to determine the maximum allowable contribution for my IRA and any additional restrictions that may apply.
Funds cannot be withdrawn or used to purchase non-marginable securities, initial public offering (lPO) stocks, or options during the first three business days. This
holding period begins on the settlement date. Additionally, these funds may not be withdrawn within the firsl 60 days the account is open, unless they are returned
by wire or ACH back to the originating bank account after the holding period (sub.iect to a wire fee). I may trade most marginable securities immedia{ely after funds
are deposited into my account.
Not all financial institutions partlcipate in ACH or wire funding. I will consuh my bank to determine if they will approve an ACH or wire transaction prior lo acceptance of
this agreement._An ACH Return Fee may be charged if the bank or linancial institution rejeas an ACH transaction. Please note: A transfer re.ject hay occur subsequent
to the posting of funds lo the account. I understand that it is my responsibility to verify the success of my ACH transaction request with my fin'ancial iirstilution.
TD Ameritrade cannot accept an electronic transaction from acmunts drawn on brokerage ac@unts or some money market accounts. Some credit unions and
savings accounts may not accept a request for an electronic transaction. Some fnancial instilutions may not accept electronic transactions from savings accounls.
The success of a transaction drawn on a credit union or savings account is subiect to the acceptance of the credit union or financial institution.
The withdrawal amount cannot exceed the cash available for withdrawal in the account. I may withdraw funds prior to settlement in a margin account; howevei
funds withdrawn before the setllement date will incur additional fees and/or interest charges. Funds cannot be withdrawn prior to settlement in a cash accounl.
The withdrawal amount cannot reduce my margin account equaty below required minimum equity levels.
lf the account is in a margin call, a withdrawal cannot be made.
Other situations may arise when an ACH transfer of funds is deemed unacceptable.
Options involve risks and are not suitable for all investors.
Address:
Overnight Address:
lnstitutional TO Ameritrade lnstitutional
919094
5010 Wateridge Vista Drive
92191-9094 San Diego, CA92'12't-S7tS
Mailing
TD Ameritrade
PO BOX
San Diego, CA
TDA| 9340 REV 06/14
TD Ameritrade lnstitutional, Division of TD Ameritrade, lnc., member FINRA/SIPC/NFA. TD Ameritrade is a trademark jointly owned by
TD Ameritrade lP Company, lnc. and The Toronto-Dominion Bank. @ 2014 TD Ameritrade lP Company, lnc. All rights reserved. Used with permission.
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