Fillable Authorization To Transfer Cash Form printable pdf download

Authorization To Transfer Cash Form

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AUTHORIZATION TO TRANSFER CASH

I authorize the transfer of the following cash according to the information provided below.

ACCOUNT INFORMATION

SENDING ACCOUNT

This is a Scottrade Bank account

This is a Scottrade Brokerage account.

(This form cannot be used to request brokerage account to brokerage account transfers. Contact your local Scottrade branch office with this type of request.)

Account Number

Account Title

RECEIVING ACCOUNT

This is a Scottrade Bank account

This is a Scottrade Brokerage account.

Account Number

Account Title

Your Relationship to Receiving Account Holder

Reason for the Request

TRANSFER INFORMATION

Transfer cash in the amount of $

Close my Scottrade Bank account.

Note: Your brokerage account must remain open in order to keep a bank account open.

I hereby agree to indemnify Scottrade, its affiliates, successors, assigns, officers, directors, agents, and employees,and hold them free and harmless from, and to promptly

pay Scottrade Bank upon demand for, any and all losses, liabilities,claims, damages, and costs (including reasonable attorney fees) or financial obligations that may arise as

a result of Scottrade Bank’s reliance on the information provided in this document, and from acting upon instructions believed by Scottrade to have originated with me. This

indemnity is in addition to, and no way limits or restricts any rights or responsibilities that have been made under any other agreement or agreements between me and

Scottrade Bank.

Account Holder's Signature

Date

Joint Account Holder's Signature

Date

*BA9330*

Signature Verified By

BA9330/4-14