Questions? Go to Fidelity.com or call 800-343-3548. One ...

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One-And-The-Same Letter

Use this form to notify Fidelity of any slight discrepancies in the way your name is listed on your Fidelity account and the account from which your assets are being transferred. For complete name changes, such as due to marriage or divorce, complete the Name Change form and include the appropriate legal documents such as a marriage certificate or divorce decree. Do NOT use this form for employersponsored accounts. Type on screen or print out and fill in using CAPITAL letters and black ink. If you need more room for information or signatures, make a copy of the relevant page.

1. Account Owner

Enter full first and last name as evidenced by a government-issued, unexpired document (e.g., driver's license, passport, permanent resident card).

Name on Fidelity Account

First Name

Middle Name

Social Security or Taxpayer ID Number

Last Name

Examples of Alternate Name: nickname; alternate spelling; Jr./Sr.; or

use of initials.

Name on Account Being Transferred

First Name

Middle Name

Last Name

2. Signature and Date Account owner must sign and date.

By signing below, you: ? Certify that the two names indicated above refer to one and the

same person.

Name and Signature on Fidelity Account

? Authorize Fidelity to accept transactions under either name.

PRINT OWNER NAME First, Middle, Last Name

MEDALLION SIGNATURE GUARANTEE

D AT E

SIGN

OWNER SIGNATURE

X

DATE MM/DD/YYYY

X

Name and Signature on Account Being Transferred

PRINT OWNER NAME First, Middle, Last Name

MEDALLION SIGNATURE GUARANTEE

SIGN

OWNER SIGNATURE

X

DATE MM/DD/YYYY

X

D AT E

Did you print and sign the form, and attach any necessary documents? Send the form and any necessary documents to Fidelity. Fidelity will send a confirmation to you.

Questions? Go to or call 800-343-3548.

Regular mail Fidelity Investments PO Box 770001 Cincinnati, OH 45277-0002

Overnight mail Fidelity Investments 100 Crosby Parkway KC1K Covington, KY 41015

On this form, "Fidelity" means Fidelity Brokerage Services LLC and its affiliates. Brokerage services are provided by Fidelity Brokerage Services LLC, Member NYSE, SIPC. 615791.4.0 (11/19)

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