Fillable Bank Payable On Death Beneficiary Plan Agreement Template printable pdf download

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BANK PAYABLE ON DEATH BENEFICIARY PLAN AGREEMENT

In order to have a Payable on Death (POD) Beneficiary Plan ("Plan") you must open an Individual or Joint Scottrade Bank

Account. Please note, the Plan covers the funds

in your Bank Account upon your death (or the death of the final account holder). Those funds will be distributed to the beneficiary(ies) designated in this POD Beneficiary

Plan Agreement ("Agreement") or in subsequent revisions submitted to Scottrade Bank. The Plan will take precedence over any estate plan established through a will or a

trust, so you are advised to consult with your tax and estate planning professionals prior to signing this Agreement.

1. POD BENEFICIARY PLAN INFORMATION

Check one of the following options:

Registering for a POD Beneficiary Plan

Previously registered for a POD Beneficiary Plan and submitting this form only to change beneficiary information.

Yes

Do you currently have a Scottrade Bank

Account? (If no, this form must accompany an account application)

Account Type:

Individual

Joint

Account Title

Scottrade Bank Account Number

Address

State

ZIP

City

2. BENEFICIARY DESIGNATION

If additional beneficiaries are requested, please use a second page. Beneficiaries must be an individual or trust; other entities are not allowed. Balances will be paid in accordance with the

percentages indicated below, which must add up to 100% (if not, or if no percentages are indicated, balances will be paid equally between all beneficiaries). Balances will be distributed

upon (i) adequate notice to Scottrade Bank of the death of the last to die of all account owners, and (ii) the completion of any required procedures and documentation. In the event a

beneficiary is deceased, his or her designated share will be distributed pro rata to the remaining living beneficiaries.

Beneficiary's Name

Date of Birth

Relationship to Account Holder

Address

Social Security or Tax ID Number

City

State

ZIP

Daytime Telephone Number

Designated Percentage

Beneficiary's Name

Date of Birth

Relationship to Account Holder

Address

Social Security or Tax ID Number

City

State

ZIP

Daytime Telephone Number

Designated Percentage

Beneficiary's Name

Date of Birth

Relationship to Account Holder

Address

Social Security or Tax ID Number

City

State

ZIP

Daytime Telephone Number

Designated Percentage

Date of Birth

Relationship to Account Holder

Beneficiary's Name

Address

Social Security or Tax ID Number

City

State

ZIP

Daytime Telephone Number

Designated Percentage

SIGNATURES - By signing this Agreement, I acknowledge that I have read and agree to the accompanying Designated Beneficiary Plan Terms and Conditions.

All account owners must sign for this form to be valid.

Print Name

Signature

Date

Print Name

Signature

Date

*BA9304*

Signature Page

Signature Verification via

Application

Associate Initials