Ameritrade - Cyr Financial

E
MOVE MONEY
Ameritrade
ADVISOR AUTHORIZATION
lnstitutional
Account #
Advisor #
Case #
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 information. For retirement Move
Money authorization, please complete and submit an IRA Move Money form. There are certain types of distribution instruclions that cannot
be pre€uthorized with this form. An appropriate 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 remrd
o
o
INVESTMENT
Name of the Advisory Firm you wish to have Move Money autholization on your behalf:
TYPE OF REQUEST
E
New
instructions
E
E Remove ALL authorizations
Replace existing instructions
(all existing ACH. Fed Wie, and lnlernal Transfer Move Money lnvestment Advisor authorizations on account will be removed)
Social Secunty Number;
Name (Fref, Middle lnitial, Last)l
Secondary Telephone Number:
Primary Telephone Number:
AUTHORIZED METHOD(S) OF PAYMENT (SELECT ALL THAT APPLY)
l^/ve authorize my/our lnvestment Advisor to utilize the following methods to disburse funds from, or to contribute funds to (ACH and internal
transfers only), my/our account for one-time or recurring cash transaclions:
NOTE: THIRD PARTY REQUESTS MAY REQUIRE PHONE VERIFICATION
I
Like-Titled lnternal Transfers*
E Third Party lnternal Transferc (Complete section 5)
lX Checks to the Address
B
of Record'
ACH (Complete section 7)
EI Fed Wires (Complete section 8)
to the address on record. This authority is gtanted within the Limited Power of AUuney language included on this form.
INTERNAL TRANSFERS' (IF APPLICABLE)
Account Registration:
Accounl Registration:
Destination Account Number:
Accounl Registration:
Account Re9istration:
* Certain
other restrictions apply.
ACH AUTHORTZATTON FOR OTHER ACCOUNT(S)
By signing the Accounl Owner Authorization below l/we, each of the regislered holders of the other account(s) specified below authorize TD Ameritrade to act
upon the instructions of the lnvestment Advisor named above to: (i) initiate credit entries to the other account(s) and to credit that account; (ii) initiate debit entries
to the other account(s) and to debit that account; and (iii) initiate reversals to the other account(s) of erroneous or duplicate credit or debit entries and to credit or
debit the other account(s) as appropriate. l/vve agree to jointly and severally indemnify and hold TD Ameritrade harmless for any liabilities occurring as a result
of TD Ameritrade relying on this authorization or anstructions given pursuant to it. l/}ve acknowledge thal these transactions shall be governed by the Rules of
the National Automated Clearing House Association and other applicable rules or regulations, and agree to abide by such rules. l^/ve agree to setfle by binding
arbitration any dispute involving TD Ameritrade that may arise with respect to the Move Money Service. This authorization will remain in full force and effect until
TD Ameritrade has received nolification of its termination, such notice which may be provided by any of the registered owners of the other account(s) at any time
by writing to TD Ameritrade lnstitutional (5010 Wateridge Vista Dri\re, San Diego, CA92121-5775, phone 8OO-431-3500). l^/l|/e acknowtedge that TD Ameritrade
must receiw this notification in a trme and manner so as to give TD Ameritrade and the other financial inslitution(s) a reasonable opportunity to act on it.
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Page 1 of 4
TDA| 9341 REV 06/14
ACH BANKS OF RECORD (IF APPLICABLE)
Authorize ACH Direction (select one or
Select
E TD Ameritrade to Bank E Bank
bthl:
to TD Ameritrade
one: E Checring E Savings
Bank Name:
ABA (Routhg) Number:
Bank Citylstate:
Bank Phone Number
Name on Bank Acmunl (exacl):
Bank Ac@unt Numberi
Please attach voided check.
ADDITIONAL BANK (OPTTONAL)
E
Authorize ACH Direction (select one or botlhJ:
Selectone:
E0hecking
TD Ameritrade to
Bank E Bank to TD Ameritrade
ESavings
Bank Name:
ABA (Routing.) Number:
Bank City/State
Bank Phone Number:
Name on Bank Acrcunl (oxact):
Bank Acmunt Number:
Please attach voided check.
DELIVERY DETAILS
DOMESTIC WIRE INFORMATION
Receiving Bank Name:
Bank City/State;
Bank Telephone #:
ABA,/Routing #:
Receiving Bank Account #:
Name on Receiving Bank Acmunt (/ist name as
it
appears at Bank and if name contains initials. please provide full name):
Please provide the following information if this request is for an escrowlmortgage or brokerage account:
For Further Credit to Name (iframe conlains initials, please provide full name):
to:
!
!
Escrow/Mortgage File #
Brokerage Account #
OPTIONAL: lntermediary Bank (P/ease verify this information with the receiving bank above if applicable)
lntermediary Bank ABA,./Routing #l
lntemediary Bank Name:
lntermediary Bank City/State:
INTERNATIONAL WIRE INFORMATION (to ensure accuracy, please contact financial institution for correct routing information)
lntemational wires requests may require disclosure of fees. lf we cannot reach you by phone, your lnternational wire request may be cancelled.
lntemational Bank Name:
Bank Street Address:
Bank Telephone #;
tsank L;rty/counlry:
SWIFT/BlC Code:
Additional Bank Routing lnlomation
-
(such as, Sorl
-
U.X., IBAN
-
Euro, Transit
-
Canada, CLABE
-
Mexico, etc.).
Name on Rseiving Bank Account (Llsl name as il appearc at Bank and if name @ntains initials, please prcvide full name):
Receiving Bank Acrcunt #:
For Further Credit Name and Aaount # (if applicable):
Purpose of Wire EEOUIRED) Providing a non-specific purpose may cause delays in prccessing the wire request:
Page2of 4
TDA| 9341 REV 06/14
l^/\/e hereby agree to indemnify and hold harmless TD Ameritrade, lnc., its affiliates and theirdirectors, officers, employees, and agents from
and aqainsi allclarms, actions;costs, and |labilities, including atlo.ney's fee arising oul ol or €laled to, reliance on this authorization and to pay
promp,'Uy on demand any and all loss€s ansing there from oidebit balance due lhereon. ln all such purchases. sales. or trades you are aulhorized
io follbvi the instruclioni of my/our Agenl in eiery concern concernrng my/our account with yout and my/our Agent is authorized to acl for me/us
and on my/our behalf in the same m,nner and wilh the same torce and effect as I /we might or could do wlh respect to such purchases, sales,
or trades, as vt€llas wllh respect to allother things necessary o. incidentalto the furthe€nce or conduct of such pu.chases, sales, ortrades,
including the delivery of moriies frorr the account in lhe Account Owner's(s ) name(s) to an account in lhe Accounl Owner's(s') name(s).
l^/ve hereby ralrfy and confirm any and all transactions with you heretofore or hereafter made by my/our Agent for my/out account. This
authorizati6n and rndemnity rs rn addrtron to, and in no way lim s or restricls, any rights thal you may have under any other agreement or
agreements belween me/us and TD Ameritrade.
This authorization is a continuing one and shall remain in full force and effecl and you shall have no duty of inquiry- l/We may change or revoke
this authorization by a written notice addressed and delivered lo TD Ameritrade. lJntil you receive such written revocation, you are entitled to
act in reliance on thts authohzation and indemnity. Any revocatron of lhis authorization shall have no effecl on any liability that results from
lransactions initiated before you receive written notice oI revocation. This aulhorizatron and rndemnity shall inure to the benefit of your presenl
firm and of any successor liam or firms, irrespective of any change or changes at any time in the personnel thereof for any causes whaisoever,
and of the ass qns of your present llrm or any successor lirms.
l/we havs carefully read lhis power of atlorney and indomnity and undeBtand thal it aulhorizes my/our Agentnamed heleln lo
exorclse rights and powers over my/ou. accounts as it l/we had Gxorclsed them myself/ourselv6, and that my/our Agent'a actions
and lnstructlons with rospecl to my/our accounts are fully binding on m€/us.
As the accounl owner(s), l^ve grant disbursement and/or contribution authority to the tollowing lnvestment Advasor in accordance wrth the
elections made on this f6rm. nrr'e acknowledge that l^^/e am/are a registered account owner on any other accounts indicated from which llr.,e
may request transfers to my/our TD Ameritrade account.
The aulhority l/we am/are granting to my/our lnvestment Advisor is subject to the attached Terms and Condilions of this service and this
Advisor Autliorizaton l/We understand ihat this authorization only allows my/our lnveslment Advisor to provide Move Money instructions
between my/our TD Amerifade accounl and any olher accounts ihdicsted. and does nol enable my/our lnveslment Advrsor to insiruct
TD AmerifAde to make other types of disburseirent requests al its direclrcn, parircularly third-pari requests. or lo request additional
information regaading such disbursements.
By signing below l/we authorize the electronic transfer of funds between my/ourTD Ameritrade account and lhe other account(s) srecified
a6ove to ii\e provisions of this Advisor Disbursemenl Authonzation and which Uwe acknowledge receiving and reviewing, which will gov€rn all
transactions inilaated under the Move Money servrce l/}ve certfy lhal all the rnlorrnatron provided on lhis form is true and accurale, and that
TD Ameritrade shall have no obligation to verify account regrskation information. lruVe expressly assume the responsibility for any adverse
consequences that may resull from Move Monily transact@ns. and l/we indemnfy and hold harmless TD Amenlrade. lnc . their divisions.
ofiicers, employees, directors, representatives, owners affiliales, successors, and assrgns. This aulhorization remajns in efiect untilsuch lime
that TD Ameritrade receives writlen notificalion of its termination.
By Bidnino this seclion. I graot my lnve3lment Advisor at the loo of ihis fo.m authoritv to .soueBt lransfer of fundB on mv behall
TD AnEdtracl€ Account Owner Signalue:
TO &r€dkacle Accouol
Co-Owner Signatur€ fif applicaDl4i
TD Amenlrade Account
Coowner Sttnalur8 f,, applicaD&)i
PLEASE READ THIS AGREEMENT CAREFULLY ln this Agreement, "1", "me", 'my", \^/e', 'us', and 'our" reler to the individuals or parties who
are the accounl owners, have an inlerest in the account, and consenl to be bound by the terms of this Agreement. The following is a legally
binding contract between me and TD Amedtrade lnstitutional, Division of TD Ameritrade, lnc. (TD Ameritrade). This agreement go\erns my
use of the TD Ameritrade website (\rebsite), services and conlent in relation to funding ot my TD Amerifade account through the use of an
Ai.rtomated Clearing House (ACH) Transaction. Please note thal the ACH Transaction Client Agreement (Agreement) does nol sup€rsede or
limit the Terms and Conditions that govern my TD Ameritrade account.
Changes to tho Cli6nt Agr6€m.nl
The policies outlined below are not all-inclusive and may be subject to change. TD Ameritrade reserves the righl to amend, change, and revise
the Agreement at anytime and without prior notice to me. TD Ameritrade willpost such amendmenls, changes, or modiflcations on lhe \tebsite,
or at ils option, may otherwise choose to deli\/erto me, electronically or otherwise, the amendments, changes, or modilicalions or the amended
Agreemenl. My continued use of lhe \4€bsite and the Seruices afrer the amended Agreement is posted on the wetsile constitules my agreement
to and acaeptance of lhe amended Agreement, regardless ot whether I have actually read the amendments, changes, or modmcations.
Terms of Usago
I understand that TD
Ameritrade provides ACH and wire services for the pramary purpose of the purchase or sale of secuities.
As applicable, TD Amedtrade lnay modify the client's electronic bank instruclrons. From time lo time, TD Amerilrade, as the originatoi may
receive a notification of change (NOC)from the client's bank. This may occurwhen previously provided bank ihslructions have beclme
outdaled due lo changes with the respective bank skuclure/organization. The Originator is obligated under industry regulation (NACHA 5.3.2)
to effect these updales initiated by the client's bank.
Electrorlc Oelhlcry of lniormatlon
I undersland lhat TD Ameitmde may electronically deliver to me or my advisor informalion aboul electronic funding, including information about
bank setup(s), status of rry deposits or withdrawals request(s), and any other informalion necessary lo complete my requesled transactions.
I understand that 'eleclronically deliver" means that TD Ameritrade may communicate such information to me or my advisor by email or by
posting the informalon on the TD Ameritrade website (where I can read aod print the jnformation).
I understand lhat delivery ol information relaled to my bank setup does nol guarantee lhe acceptance of an ACH transaction by my
financial instiiution.
Page3d4
TDAI9341 REV Od14
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 Services Representative at 800-431-3500 or by writing to TD Ameritrade at:
Mailing Address:
TD Ameritrade lnstitutional
PO BOX 919094
San Diego, CA 92191-9094
Overnight Address:
TD Ameritrade lnstitutional
5010 Wateridge Vista Drive
San Diego, CA 9212'l -5775
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, subiect to restrictions. This action is not a confirmation that my financial institution or TD Ameritrade has completed the transfer of
funds. I understand that a transfer reject may occur, even subsequent to account fundrng. 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, attempt to
contact my advisor by email andior 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 transaction from a joint bank account may be deposited into either bank account owner'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 account owner. I understand that
I am responsible for understanding any tax ramifications related to making a deposit into my lRA.
To complete an IRA contribution I must complete an electronic deposit form.
I acknowledge that any funds being withdrawn from a UTMA or UGMA account will be used exclusively for the benefit of the minor.
I understand the following restrictions:
TD Ameritrade currently imposes no transaction charges in connection with my use of ACH or wire transfers. TD Ameritrade does, howeve6
charge a fee on direct deposit and electronic funds transfer items that are returned to TD Ameritrade due to insufricient 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 reserves 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 lo 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 contacl a tax advisor to determine the maximum allowable contribution for my lRA 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 setlement date. Additionally, these funds may not be withdrawn within the tirst 60 days the
account is open, unless they are returned by wire or ACH back to the originating bank account after the holding period (subject to a wire fee).
I may trade most marginable securities immediately after funds are deposited into my account.
Not all financial institutions participate in ACH or wire funding. I will consult my bank to determine if they will appro\€ an ACH or wire transaction
prior to acceptance of this agreement. An ACH Return Fee may be charged if the bank or financial institution rejects an ACH transaction. Please
note: A transfer reject may occur subsequent to the posting of funds to the account. I understand that it is my responsibility to verify the success of
my ACH Transaction request with my financial institution.
TD Ameritrade cannot accept an electronic transaction from accounts drawn on brokerage accounts or some money market accounts. Some
credit unions and savings accounts may not accept a request for an electronic transaction. Some financial institutions may not accept electronic
transactions from savings accounls. The success of a transaction drawn on a credit union or savings account is subject to the acceptance of
the credit union or Iinancial 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; however, funds withdrawn before the settlement date will incur additional fees and/or interest charges. Funds cannot be withdrawn
prior to settlement in a cash account.
The withdrawal amount cannot reduce my margin account equity 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:
Institutional TD Ameritrade lnstitutional
PO BOX 919094
5010 Wateridge Vista Drive
San Diego, CA 92191-9094 San Diego, CA92121-5775
Mailing
fD Ameritrade
rDAt 9341 REV 05/14
TD Ameritrade lnstitutional, Division of TD Ameritrade, lnc., member FINRIi/SIPC/NFA. TD Ameritrade is a trademark jointly owned by
TD Amerikade lP Company, lnc. and The Toronto-Dominion Bank. @ 2014 TD Ameritrade lP Company, lnc. All rights reserved. Used with permission.
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