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WellsTrade® Customer Account Transfer
Sub Firm #
Doc Code
205
WTACAT
Account Number
First Clearing #
0141
(Office Use Only)
Questions 1-800-TRADERS. We're here for you 24/7.
Avoid potential delays! Fax or mail with this form with a recent
account statement attached to:
Fax: (800)433-0738
Address: 1 N Jefferson Ave, MAC H0004-014, St. Louis, MO 63103
1. WellsTrade Account You Are Transferring Into
2. Account You Are Transferring From
Account Number
Account Number (Only one account # can be used per form)
Soc Sec Num / Client Tax ID Number
Soc Sec Num Secondary / Tax ID Number
Name of Financial Institution
Account Titling
Account Titling (exactly as it appears on your statement)
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
Owner’s Address
Financial Institution’s Address
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
(select only one)
Non-Retirement Account Type
Single
Corporate
(select only one)
Non-Retirement Account Type
Joint
Trust
UTMA/UGMA
Other _______________________
Estate
Single
Corporate
Retirement Account Type (See page 2 for Retirement Account Reminders)
Roth IRA
401(k)
SEP IRA
Traditional IRA
SIMPLE IRA
Education Savings
Joint
Trust
UTMA/UGMA
Other _______________________
Estate
Retirement Account Type (See page 2 for Retirement Account Reminders)
Qualified
Other _______________
Roth IRA
401(k)
SEP IRA
Traditional IRA
SIMPLE IRA
Education Savings
Qualified
Other _______________
Please note that a statement dated within the last 90 days is REQUIRED for this form to be processed.
3. Transfer Instructions (select one)
A. Entire Account Transfer
Full In Kind – transfer your entire account exactly as it is without selling
anything. Note: If checked, skip Section 4 – Individual Assets.
Full Liquidation – sell all assets and transfer proceeds as cash.
Note: If checked, skip Section 4 – Individual Assets.
Full Combination (In Kind and Liquidation) – sell only assets listed in
Section 4 under Individual Assets and transfer proceeds as cash;
transfer remaining assets in kind.
D. Liquidate and Transfer Certificate of Deposit (CD)
Upon Maturity – the maturity date is _________________.
B. Transfer Part of My Account (your account will remain open)
Only transfer assets or cash proceeds as listed in Section 4 under
Individual Assets.
E. Annuity Liquidation (check one only)
Immediately and entirely (There may be a penalty and/or surrender
charge)
–or–
Penalty-free amount only
Percent or Amount: __________________ (if percentage not indicated,
C. Transfer Mutual Funds Purchased Directly from a Mutual Fund
Company
Mutual Funds shares. List each fund in Section 4, Individual Assets.
Mutual Fund Certificates. Please see Page 4 for instructions.
(submit 4 weeks before maturity date to process prior to renewal)
–or–
Immediately – (There may be a penalty and/or surrender charge)
Percent or Amount: __________________ (if percentage not indicated,
liquidate all.)
liquidate all.)
4. Individual Assets
Only use this section for partial account transfers, transfers of mutual funds owned directly with a mutual fund company, or to request specific assets to
be sold and the proceeds transferred as cash.
IF NOT
COMPLETED
ASSUMED
CHOICE IS
IN-KIND
Cash $_____________________________
(Cash not applicable for Mutual Funds Company Transfers)
Asset Description
Symbol / CUSIP
Transfers
Quantity
All
______________
All
______________
All
______________
All
______________
All
______________
(Must be checked
for each asset)
In-Kind
Sell
In-Kind
Sell
In-Kind
Sell
In-Kind
Sell
In-Kind
Sell
Mutual Fund
Account Number
(if owned directly at the mutual fund company)
IF NOT COMPLETED ASSUMED
CHOICE IS REINVEST
Mutual Fund
Mutual Fund
Capital Gains Option Dividends Option
(select one)
(select one)
Reinvest
Reinvest
Cash
Cash
Reinvest
Reinvest
Cash
Cash
Reinvest
Reinvest
Cash
Cash
Reinvest
Reinvest
Cash
Cash
Reinvest
Reinvest
Cash
Cash
SR#
587368 (Rev 06 – 04/14) Page 1 of 5
Individual Assets – continued
IF NOT
COMPLETED
ASSUMED
CHOICE IS
IN-KIND
Asset Description
Symbol / CUSIP
Transfers
Quantity
Mutual Fund
Account Number
(if owned directly at the mutual fund company)
Mutual Fund
Mutual Fund
Capital Gains Option Dividends Option
(select one)
(select one)
All
______________
In-Kind
Sell
Reinvest
Cash
Reinvest
Cash
All
______________
All
______________
All
______________
All
______________
All
______________
In-Kind
Sell
In-Kind
Sell
In-Kind
Sell
In-Kind
Sell
In-Kind
Sell
Reinvest
Cash
Reinvest
Cash
Reinvest
Cash
Reinvest
Cash
Reinvest
Cash
Reinvest
Cash
Reinvest
Cash
Reinvest
Cash
Reinvest
Cash
Reinvest
Cash
All
______________
All
______________
All
______________
All
______________
All
______________
In-Kind
Sell
In-Kind
Sell
In-Kind
Sell
In-Kind
Sell
In-Kind
Sell
Reinvest
Cash
Reinvest
Cash
Reinvest
Cash
Reinvest
Cash
Reinvest
Cash
Reinvest
Cash
Reinvest
Cash
Reinvest
Cash
Reinvest
Cash
Reinvest
Cash
All
______________
All
______________
All
______________
All
______________
All
______________
All
______________
All
______________
All
______________
All
______________
All
______________
All
______________
All
______________
All
______________
All
______________
All
______________
All
______________
All
______________
All
______________
All
______________
In-Kind
Sell
In-Kind
Sell
In-Kind
Sell
In-Kind
Sell
In-Kind
Sell
In-Kind
Sell
In-Kind
Sell
In-Kind
Sell
In-Kind
Sell
In-Kind
Sell
In-Kind
Sell
In-Kind
Sell
In-Kind
Sell
In-Kind
Sell
In-Kind
Sell
In-Kind
Sell
In-Kind
Sell
In-Kind
Sell
In-Kind
Sell
Reinvest
Cash
Reinvest
Cash
Reinvest
Cash
Reinvest
Cash
Reinvest
Cash
Reinvest
Cash
Reinvest
Cash
Reinvest
Cash
Reinvest
Cash
Reinvest
Cash
Reinvest
Cash
Reinvest
Cash
Reinvest
Cash
Reinvest
Cash
Reinvest
Cash
Reinvest
Cash
Reinvest
Cash
Reinvest
Cash
Reinvest
Cash
Reinvest
Cash
Reinvest
Cash
Reinvest
Cash
Reinvest
Cash
Reinvest
Cash
Reinvest
Cash
Reinvest
Cash
Reinvest
Cash
Reinvest
Cash
Reinvest
Cash
Reinvest
Cash
Reinvest
Cash
Reinvest
Cash
Reinvest
Cash
Reinvest
Cash
Reinvest
Cash
Reinvest
Cash
Reinvest
Cash
Reinvest
Cash
For more assets attach an additional page 1A.
587368 (Rev 06 – 04/14) Page 1a of 5
(Must be checked
for each asset)
IF NOT COMPLETED ASSUMED
CHOICE IS REINVEST
Terms & Conditions
Client Instructions to Delivering Firm
If this account is a qualified retirement account, I have amended the applicable plan so that it names First Clearing, LLC (FCC) as
successor custodian. Unless otherwise indicated in the instructions above, please transfer all assets in my account.
I understand that to the extent any assets in my account are not readily transferable with or without penalties, such assets may not be
transferred within the time frames required by FINRA Rule 11870 or similar rule of other designated examining authority. I authorize you
to liquidate any nontransferable proprietary money market fund assets that are part of my account and transfer the resulting credit
balance. I authorize you to deduct any outstanding fees due you from the credit balance in my account. If my account does not contain a
credit balance, or if the credit balance in the account is insufficient to satisfy any outstanding fees due you, I authorize you to liquidate the
assets in my account to the extent necessary to satisfy that obligation. If certificates or other instruments in my account are in your
physical possession, I instruct you to transfer them in good deliverable form, including affixing any necessary tax waivers, to enable the
successor custodian to transfer them in its name for the purpose of sale, when and as directed by me. I understand that upon receiving a
copy of this transfer instruction, you will cancel all open orders for my account on your books. I affirm that I have destroyed or returned to
you credit/debit cards and/or unused checks issued to me in connection with my securities account. I understand that you will contact me
with respect to the disposition of any assets in my securities account that are non-transferable.
• I understand that fractional shares may not transfer in kind and may be required to be liquidated to complete a full transfer.
• When applicable, I authorize the delivering firm to discontinue all account management agreements immediately. The client will have
sole responsibility for investment decisions with respect to the securities, cash and other assets in the client's account until the client
hires a new investment decision manager.
• CLIENT PLEASE NOTE: (Applicable to retirement accounts only) Regular IRA contributions can be commingled with rollover/direct
rollover contributions. Please consult with a tax advisor to determine the best option for your situation. I understand and
acknowledge that commingling may preclude me from rolling funds from my IRA to another qualified plan or 403(b) plan.
IRA Direct Rollover from Qualified Retirement Plan (QRP) Irrevocable Election
A direct rollover is a reportable distribution from a QRP to an IRA or another QRP. Due to the important tax consequences associated
with rolling over funds or property to an IRA from an employer held plan, when you sign this Customer Account Transfer form, you
acknowledge the following: the IRA Custodian is not responsible for providing you with tax or other legal advice; you have been advised
to see a tax professional and no broker or other employee is authorized to give such advice. You are aware that the rollover from the
QRP is an irrevocable election and you are certifying that all information provided on this form is true and correct. You are certifying that
you understand the rules and conditions associated with making a direct rollover and that the assets being moved from the QRP are
eligible for rollover into an IRA or another QRP. You are also assuming full responsibility for this direct rollover transaction and will not
hold the IRA Custodian liable for any adverse consequences that may result.
Age 70½ Required Minimum Distribution (RMD) Retirement Account Reminder
If you are age 70 1/2 or older, or if you will attain age 70 1/2 this year, the IRS requires that the first monies withdrawn from your
retirement account be your required minimum distribution (RMD) for the year. Although the IRS permits you to transfer your RMD
between like IRAs, you are not permitted to roll over an RMD even as a direct rollover from a QRP. Be sure to satisfy your RMD before
requesting a direct rollover. If you need additional information about this requirement, please contact your legal or tax advisor.
Auction Rate Securities: Account Transfer Acknowledgement
You understand and agree to the following in connection with the auction rate securities held in your account:
• Your auction rate securities were purchased prior to the transfer of your account to us. As a result, we are not responsible or liable
for any prior recommendations or advice with respect to these securities nor are we under any obligation to provide you with any
investment recommendation or advice with respect to the disposition or continued holding of these securities in your account
following the transfer of your account.
• You also understand and agree that we are not under any obligation to you (i) to provide loans under margin agreements or
otherwise secured in whole or part by the auction rate securities in your account, (ii) to purchase or continue to purchase any
auction rate securities in periodic rate setting auctions or in secondary market transactions, or (iii) to provide liquidity for such
securities. Many auctions for these securities are in failed status meaning that holders of these securities are not able to sell these
securities in the periodic rate setting auctions or in secondary market transactions and as a result, liquidity for these securities
currently is greatly impaired. We provide no assurance that you will be able to sell or otherwise dispose of these securities following
the transfer of your account to us. You understand that we take actions in connection with other customers that we do not offer you
in connection with your auction rate securities.
Revocation of Advisory Agreements
When applicable, I authorize the delivering firm to discontinue all account management agreements immediately. The client will have
sole responsibility for investment decisions with respect to the securities, cash and other assets in the client's account until the client
hires a new investment decision manager.
Margin Agreements
Accounts for which the client signed Margin Agreement has not been received by the Firm may be subject to restriction, sellout, and
closure after review by the Credit Margin Department.
Wells Fargo Bank, N.A. Agency Accounts
This document constitutes my instruction to Wells Fargo Bank, N.A. to terminate the above referenced account and transfer as instructed
to First Clearing, LLC.
587368 (Rev 06 – 04/14) Page 2 of 5
5. One and Same Name Certification
Use this section if there is any difference in the way the account owner's name appears on the different accounts, and there is no actual change in
ownership.
This is to certify that _______________________________________________________(print name)
and __________________________________________________________ (print name) are one and the same person.
Please sign as both ways the Account Owner’s name appears (you must also sign in Section 7):
Signature
Print Name
Date
Print Name
Date
X
Signature
X
6. Authorization to Change Registration
By completing this section, you are authorizing a transfer that will change the account ownership. This is not applicable for retirement
accounts. The firm you are transferring from may need additional paperwork to change the registration to your WellsTrade account.
See Page 5.
Account Owner(s) Name on Account Transferring
Account Number
Social Security Number / Tax ID
Account Owner(s) Name, WellsTrade Account
Account Number
Social Security Number / Tax ID
I understand and accept the change of registration and ownership and hold Wells Fargo Advisors, First Clearing, LLC and the delivering firm harmless from acting on the
above instruction.
7. Acknowledgement & Signatures
All Account Holders must sign and date. If acting as a fiduciary (such as Power of Attorney, Trustee, Executor), please sign in that capacity.
I/We, the undersigned, acknowledge that I/we have read, understand, and agree to be bound by the terms & conditions.
Account Owner Signature
Account Owner Name (print)
Date
Account Owner Name (print)
Date
Account Owner Name (print)
Date
Account Owner Name (print)
Date
Account Owner Name (print)
Date
Account Owner Name (print)
Date
X
Account Owner Signature
X
Account Owner Signature
X
Account Owner Signature
X
Account Owner Signature
X
Account Owner Signature
X
Signature Guarantee
Custodian Acceptance – Office Use Only
Be advised that First Clearing, LLC accepts appointment as Successor Custodian. Contact:
X______________________________________________
__________________________ Phone: ___________________
Successor Custodian Signature
__________________________
Date (must be completed)
Account Transfers
Phone: (855) 372-3526
Mutual Funds Department
Phone: (314) 955-2689
Investment and Insurance Products:
Not Insured by FDIC or any Federal Government Agency
May Lose Value
Not a Deposit of or Guaranteed by a Bank or Any Bank Affiliate
Wells Fargo Advisors, LLC is a registered broker-dealer and separate non-bank affiliate of Wells Fargo & Company
587368 (Rev 06 – 04/14) Page 3 of 5
Instructions
Transfer Assets to WellsTrade
•
•
•
•
•
•
®
Use this form to transfer your account from another firm to WellsTrade.
If your transfer is a rollover from a workplace retirement plan such as a 401(k) or 403b, please contact your former
employer or retirement plan provider for rollover instructions. They may require you to complete paperwork they provide.
If an asset cannot be held in your WellsTrade account, you will be notified and provided other available options, including
selling the asset and transferring the cash proceeds to WellsTrade or maintaining the asset at your previous firm.
Certain transfers may raise legal or tax issues or financial risk. Consult your legal, financial or tax advisor before
completing any transfers.
Use one form for each account you are transferring to WellsTrade.
If you are opening a new WellsTrade account, please apply online at wellsfargo.com or call us at 1-866-224-5405 for
assistance.
IMPORTANT: We need your most recent (typically within the last 90 days) account statement from the firm you are transferring
from.
Questions - We’re here to help 24 hours a day, 7 days a week. 1-800-TRADERS
How to Complete this Form
1.
2.
3.
Section 1. Information for your WellsTrade account. Please complete the entire section. Your name and account titling
should be exactly as it appears on your statement.
Section 2. Information for the account you are transferring. Please complete the entire section. Your name and account
titling should be exactly as it appears on your statement. Please provide the address for your old firm so we can contact
them directly with your transfer request.
Section 3. Transfer Instructions - choose only one type of transfer (A – E):
A - Transfer Entire Account – transfer all assets to WellsTrade and close your old account.
In kind – transfer your entire account exactly as it is without selling anything.
Liquidations – let us know if you want to sell all or only some of your assets. If you want to sell only certain
assets, please list them in Section 4, Individual Assets. You may need to contact your current firm directly to sell
assets as some firms will not accept instructions from Wells Fargo Advisors. For Mutual Fund Transfers, where
the fund is held directly at the fund firm, you should use Section 4, Individual Assets of this form to facilitate the
liquidation.
B - Partial Account Transfer. Only transfer certain assets to WellsTrade and your old account will remain open. List
each asset in Section 4, Individual Assets, and let us know if you want us to instruct your old firm to sell and transfer
proceeds as cash or transfer in kind. You may need to contact your current firm directly to sell assets as some firms will
not accept instructions from Wells Fargo Advisors. For Mutual Fund Transfers, where the fund is held directly at the fund
firm, you should use Section 4, Individual Assets of this form to facilitate the liquidation.
C - Mutual Fund Transfer. Transfer mutual fund shares held directly at the fund company (not at a brokerage firm or
bank). List each mutual fund in Section 4, Individual Assets, and let us know if you want us to instruct the fund company
to sell your shares and transfer proceeds as cash or transfer in kind. If you are submitting Mutual Fund Certificates,
please include the certificates along with paperwork. Send all documents via certified mail to the following address:
1 North Jefferson, Attn: Physical Transfer Department, St. Louis MO 63103
D - Certificates of Deposit (CDs) Liquidation
Upon Maturity - Request the CD be liquidated at maturity and transfer proceeds as cash. Please submit this
request one month before the maturity date in order to ensure your bank does not automatically renew.
Immediately - Request the CD be liquidated immediately and transfer proceeds as cash. You may be charged a
penalty to liquidate before the maturity date.
Percent or Amount – If you only want to transfer a portion of your CD, use this section to request a specific
amount be liquidated and transferred as cash. If this section is left blank the entire CD will be liquidated.
587368 (Rev 06 – 04/14) Page 4 of 5
E - Annuity Liquidation. Annuities cannot be held in WellsTrade accounts. Your transfer choices are:
•
Immediately – You can request the annuity be surrendered (cashed-in) and the proceeds transferred as cash
immediately. There may be penalties, fees, tax implications, and a change in listed beneficiates.
•
Percent or Amount – You may request a specific amount be liquidated and transferred as cash. There may be
penalties, fees, tax implications, and a change in listed beneficiaries. If this section is left blank, the entire
amount will be liquidated.
•
Penalty-free amount – You may request only the portion that carries no penalty be liquidated and the proceeds
transferred as cash.
4.
Section 4. Individual Assets. Only use this section to list specific assets for partial account transfers, mutual fund
transfers, and/or to request specific assets be sold and the proceeds transferred as cash. DO NOT use this section for
the following types of transfers: Transfer Entire Account, Liquidate Certificate of Deposit (CD), or Annuity Liquidation.
5.
Section 5. One and Same Name Certification. Complete this section if there is any difference between the owner name(s)
on your WellsTrade account and the account you are transferring, but there is no actual change in ownership. For
example:
a. John E. Doe and J. Edward Doe is the same person, but one account uses an initial.
b. Mary Jones and Mary Smith is the same person, but one account uses married name.
6.
Section 6. Authorization to Change Ownership.
a. Complete this section if you intend to change the registration or ownership of your account. This may result in a
change in ownership rights and may change the primary social security or tax ID number on the account.
Retirement accounts are not eligible for this type of transfer. Please call us at 1-800-TRADERS with questions.
b. Your old firm may require additional documents or paperwork to change the registration to the WellsTrade
account. Depending on the specific type of change, they may ask for a letter of explanation and/or legal
documents (for example, marriage/divorce certificate, updated trust document, or proof of age such as birth
certificate or driver license). Please call us at 1-800-TRADERS with any questions.
7.
Section 7. Acknowledgement & Signatures. All owners of both accounts must sign and date.
587368 (Rev 06 – 04/14) Page 5 of 5