Mutual Fund Breakpoint Claim Form
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MUTUAL FUND BREAKPOINT CLAIM FORM
SCOTTRADE ACCOUNT INFORMATION
Account Title
Account Number
BREAKPOINT INFORMATION
Please list each of the mutual funds that you purchased from Scottrade for which you believe you
may be eligible for breakpoint discounts.
Name of Fund(s)
(Attach additional sheets if necessary)
For each of the funds listed above, please answer the following questions.
Did you make additional purchases of Class A shares through Scottrade including those where Rights of
Accumulation or Letters of Intent apply?
Yes
No
Did you purchase the same or different funds within the same fund family at Scottrade?
Yes
No
Did you purchase funds in the same family at Scottrade with different accounts such as IRAs, 401(k),
educational IRAs etc?
Yes
No
Are there any purchases of those funds by related parties such as your spouse or children?
Yes
No
Do you hold any of the funds listed above at another brokerage firm?
Yes
No
Do you hold any of the funds listed above directly with the mutual fund company?
Yes
No
If you answered yes to any of the above questions, please provide the following:
Fund 1
Fund 2
Fund 3
Fund Symbol
Mutual Fund Company Name
Name on Account
Account Number
Name of company
holding shares
(Attach additional sheets if necessary)
(If a brokerage firm is holding the shares, please provide a copy of the account statement)
PLEASE RETURN THIS CLAIM FORM TO YOUR LOCAL BRANCH.
For Scottrade Use Only
Discount Applied
Yes
No
*SF5103*
If yes, amount of adjustment
Reviewed by
Date
Attach all notes to this form
SF5103/3-15
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