Trust Account Application - TD Ameritrade

Trust Account Application

Questions? Call a New Accounts representative at 800-276-8746. Please visit us at for more information about opening an account.

Return Options:

Electronically via Message Center: Log in and go to Client Services >

Message Center to attach the file

Regular Mail: PO Box 2760, Omaha, NE 68103-2760

Overnight Mail: 200 South 108th Avenue Omaha, NE 68154-2631

Fax: 866-468-6268

1

Type of Account (Please select only one. Additional paperwork is required for

some account types.)

C Personal Trust C Other:

2

Funding Your Account

I will be funding with

C A check. Please make check payable to TD Ameritrade Clearing, Inc. C A wire transfer to be initiated after account opening. Please contact TD Ameritrade prior to initiating the wire transfer. C A transfer of assets from an existing account. Please complete and include an External Transfer Form and a copy of your

most recent statement.

C A transfer from an existing TD Ameritrade account. Please complete and include an Internal Transfer Form. C Stock certificates. Please contact TD Ameritrade prior to submitting certificates.

3

Trust Information

Title of Trust:

Date of Formation:

Date of the Last Amendment to the Trust

Please list the single Tax ID or Social Security Number under which your trust reports taxes.

Tax ID Number:

U.S. Social Security Number:

OR Grantor(s)/Settlor(s)/Trustor(s) of the Trust:

*TDA4286*

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TDA 4286 A 07/23

Section 3, Trust Information continued Home Address: (no PO Box or mail drop)

City:

State:

Mailing Address: (if different from above)

City:

State:

Primary Phone number:

C Check here if this is not a U.S. phone number

Fax number:

Name(s) of the Successor Trustee(s): (if applicable) Beneficiaries of the Trust:

Zip Code:

Country:

Zip Code:

Country:

Secondary Phone number:

C Check here if this is not a U.S. phone number

Email Address (required for electronic delivery of your account statement and trade confirmations):

Annual Income:

C $0-$24,999

C $25,000-$49,999

C $50,000-$99,999

C $100,000-$249,999

Approximate Net Worth: (not including primary residence)

C $0-$14,999

C $15,000-$49,999

C $250,000-$499,999

C $500,000-$999,999

C $50,000-$99,999 C $1,000,000-$1,999,999

Approximate Liquid Net Worth: (cash, stocks, etc.)

C $0-$14,999

C $15,000-$49,999

C $250,000-$499,999

C $500,000-$999,999

C $50,000-$99,999 C $1,000,000-$1,999,999

C $250,000+

C $100,000-$249,999 C $2,000,000+

C $100,000-$249,999 C $2,000,000+

What best describes the initial source of funds for this account?

C Employment/Wages

C Retirement Funds

C Gift

C Savings

C Inheritance/Trust

C Investments

C Unemployment/Disability

C Legal Settlement

C Lottery/Gaming

C Spousal/Parental Support C Other (describe source of funds):

What best describes the ongoing source of funds for this account?

C Employment/Wages

C Retirement Funds

C Gift

C Savings

C Inheritance/Trust

C Investments

C Unemployment/Disability

C Legal Settlement

C Lottery/Gaming

C Spousal/Parental Support C Other (describe source of funds):

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TDA 4286 A 07/23

4

Affiliations

C Check here if any Trustee, their spouse, any member of their immediate family living in the same household, including parents,

in-laws, siblings, and dependents is a member of the board of directors, 10% shareholder, or policy-making officer of a publicly traded company. Specify the name of the affiliated person/Trustee, the company name, ticker symbol, address, city, and state:

C Check here if any Trustee, their spouse, any member of their immediate family living in the same household, including parents,

in-laws, siblings, and dependents is licensed, employed by or associated with a broker-dealer firm, a financial services regulator, securities exchange, or member of a securities exchange. If checked, please specify the name of the affiliated person/Trustee and affiliated entity below. If this entity requires its approval for you to open this account, please provide a copy of the required authorization letter (with this application):

C Check here if any Trustee, their spouse, any member of their immediate family, including parents, in-laws, siblings, and

dependents is, or is employed by, a federal or state registered Investment Advisor. Specify the name of the person affiliated with the Trustee employed by the Registered Investment Advisor and Investment Advisor company name:

C Check here if any Trustee, their spouse, any member of their immediate family, including parents, in-laws, siblings, and

dependents is using a license in a professional sale or trading capacity. Specify the name of the licensed professional, their relationship to the trustee, and if associated with an entity:

5

Authorized Agent Compensation

C Check here if any Authorized Agent (unaffiliated with the entity) is being compensated for providing investment advice, placing trades, or otherwise managing the account.

6

Trustee Information

Name Prefix (optional):C Mr.C Mrs.C Ms.C Dr.C Rev.

Full Legal Name:

Date of Birth:

Number of Dependents:

U.S. Social Security Number:

Home Address: (no PO box or mail drop)

City:

State:

Zip Code:

Mailing Address: (if different from above)

City:

State:

Zip Code:

OR Tax ID Number: Country: Country:

Primary Phone number:

C Check here if this is not a U.S. phone number

Fax number:

Secondary Phone number:

C Check here if this is not a U.S. phone number

Email Address (required for electronic delivery of your account statement and trade confirmations):

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TDA 4286 A 07/23

Section 6, Trustee Information continued

Please specify if you are:

C Employed

C Unemployed

C Retired

C Homemaker

Employer Name (If Self-Employed, provide the name of your business):

C Student

C Self-Employed

Please choose from the list provided on page 11 the occupation code and industry of occupation code that most accurately describes your situation.

Occupation Code:

Industry of Occupation Code:

Employer Address:

City:

State:

Zip Code:

Country:

C Check here if you are NOT a U.S. citizen.

Country of Dual/Secondary Citizenship (if applicable):

Country of Citizenship: Country of Birth:

Non-U.S. citizens*: Do you hold a current U.S. immigration visa? C Yes C No

Specify visa type:

Visa Number:

Expiration:

* Nonresident aliens must submit a copy of a current passport and a copy of a bank or brokerage statement.

7

Co-Trustee Information

Name Prefix (optional):C Mr.C Mrs.C Ms.C Dr.C Rev.

Full Legal Name:

Date of Birth:

Number of Dependents: U.S. Social Security Number:

Home Address: (no PO box or mail drop)

City:

State:

Zip Code:

Mailing Address: (if different from above)

City:

State:

Zip Code:

OR Tax ID Number: Country: Country:

Primary Phone number:

C Check here if this is not a U.S. phone number

Fax number:

Secondary Phone number:

C Check here if this is not a U.S. phone number

Email Address (required for electronic delivery of your account statement and trade confirmations):

Page 4 of 11

TDA 4286 A 07/23

Section 7, Co-Trustee Information continued

Please specify if you are:

C Employed

C Unemployed

C Retired

C Homemaker

Employer Name (If Self-Employed, provide the name of your business):

C Student

C Self-Employed

Please choose from the list provided on page 11 the occupation code and industry of occupation code that most accurately describes your situation.

Occupation Code:

Industry of Occupation Code:

Employer Address:

City:

State:

Zip Code:

C Check here if you are NOT a U.S. citizen.

Country of Dual/Secondary Citizenship (if applicable):

Country of Citizenship: Country of Birth:

Country:

8

Non-U.S. citizens*: Do you hold a current U.S. immigration visa?C YesC No

Specify visa type:

Visa Number:

Expiration:

* Nonresident aliens must submit a copy of a current passport and a copy of a bank or brokerage statement.

Trade Confirmations and Account Statements

I understand that I will receive monthly account statements and trade confirmations electronically, unless I make a selection below. If I do not provide a valid email address, I will receive a quarterly paper statement or a monthly paper statement. Certain types of accounts or activities (such as options trading) require a monthly statement, either electronically or via U.S. mail. I will be responsible for any fees that apply. Accounts with a total liquidation value of $10,000 or an average of five trades per month over a three-month period are eligible to receive free paper statement and confirmation delivery.

If I elect to receive either electronic statements or electronic confirmations, I will receive shareholder information electronically when available.

Account Statement:

C Electronic Monthly C Paper Monthly ($2 fee may apply each month) C Paper Quarterly ($2 fee may apply each quarter)

Trade Confirmation:

C Electronic

C Paper

C Unless I have checked this box, TD Ameritrade is required to share my name and address with the companies I invest in through your

services so they may contact me directly about my investment. If I direct you not to share, you will receive the information on my behalf and will forward it to me. Shareholder information includes proxy material, prospectuses, annual reports, and other corporate communications. In some cases, regulations may require sharing information with the companies in which I have invested despite this election.

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TDA 4286 A 07/23

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