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CONTACT INFORMATION UPDATE
I (we) authorize Scottrade, Inc. to change the contact information for the following account(s):
Account Number
Account Title/Registration
Account Number
Account Title/Registration
Account Number
Account Title/Registration
Complete one or more of the sections below; these updates will apply to all of the above-listed
accounts, as well as any associated Scottrade Bank
accounts.
®
1) Physical Address - no mail receiving or incorporation services, no P.O. boxes
Street Address
City
State of Legal Residence ZIP Plus 4
2) Mailing Address
Check all that apply:
Same as Physical Address
Temporary - indicate return date:
Street Address or P.O. Box
City
State
ZIP Plus 4
3) Foreign Address - if Sections 1 or 2 indicate a foreign address, check all that apply:
I anticipate staying outside the U.S. over 6 months and my length of stay is
year(s)
month(s).
I am not a citizen or permanent resident of the U.S. and my country of citizenship is
.
4) Email Address
5) Fax Number
6) Phone Number
Preferred Number
Home
Cell
Work
Home
Cell
Signature of Account Holders
X
Account Holder's Printed Name
Date
Account Holder's Signature
X
Account Holder's Printed Name
Account Holder's Signature
Date
*SF1063*
Signature Page
ID
Signature Verification via
Application
SF1063/11-15
Associate Initials
Scottrade, Inc. - Member
FINRA
and
SIPC