Trust Account Certification Form
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2TRUST ACCOUNT CERTIFICATION
TRUST INFORMATION
Title of Trust:
Trust EIN or Living Grantor/Trustor SSN
Original Effective Date of the Trust:
Date of Last Amendment (if applicable)
Names of All Current Trustees:
Permissions - check all activities allowed in the Trust's Scottrade Brokerage Account (please note that additional paperwork may be required to add
these permissions to an account):
Trustees Acting Independently
Disbursement of Funds/Securities to a Third Party
Margin Trading
Options Trading
Check Writing
SUCCESSOR TRUSTEE INFORMATION
(You must provide successor trustee information or insert "None")
Name:
Date of Birth:
Phone Number:
Address:
CO-SUCCESSOR TRUSTEE INFORMATION
(if applicable)
Name:
Date of Birth:
Phone Number:
Address:
GRANTOR/TRUSTOR INFORMATION
Name:
Date of Birth:
Date of Death
(if applicable)
Address:
Social Security Number
ADDITIONAL GRANTOR/TRUSTOR INFORMATION
(if applicable)
Name:
Date of Birth:
Date of Death
(if applicable)
Address:
Social Security Number
As Trustee(s) of the above trust, and in connection with my account application to open and maintain a securities brokerage account
with Scottrade, I certify the above to be true, and hereby represent and warrant the provisions listed on page 2 of this Certification.
I agree to Scottrade's Trust Account Certification provisions on page 2 of this document and to indemnify and hold Scottrade
its officers, directors, employees, agents, and assigns, harmless from any loss, damage, or claim arising as a result of
Scottrade’s reliance on the information provided in this document,and from acting upon instructions believed by Scottrade to
have originated with the Trustee(s). I consent to the account permissions indicated above, and I agree to abide by the
Scottrade Brokerage Account Agreement.
ALL CURRENT TRUSTEES MUST SIGN.
X
X
X
X
Trustee Signature
Date
Trustee Signature
Date
X
X
*SF2014*
Trustee Signature
Date
X
X
Trustee Signature
Date
SF1014/4-15
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