Ira Transfer Form - Doubleline Funds Ira (Page 3 of 3) in pdf

Ira Transfer Form - Doubleline Funds Ira Page 3

Signature and Certification

I certify that I have established an IRA with the DoubleLine Funds, of which U.S. Bank, NA, is the Custodian. I agree to contact my pres-

ent Custodian from whom I am transferring to determine if specific documentation or a signature guarantee is required. I understand

that I am responsible for determining my eligibility for all transfers or direct rollovers. I agree to hold the Custodian harmless against any

and all situations arising from an ineligible transfer or direct rollover. I acknowledge that the Custodian or its agent cannot provide legal

advice and I agree to consult with my own tax professional for advice.

I authorize U.S. Bancorp Fund Services, LLC, to act on my behalf in contacting the current custodian or plan administrator to facilitate

the transfer of assets.

SIGNATURE OF OWNER [OR GUARDIAN IF IRA OWNER IS A MINOR]

DATE (MM/DD/YYYY)

SIGNATURE GUARANTEE* (FOR TRANSFERS FROM ANOTHER CUSTODIAN)

IMPORTANT: Please contact your current Custodian to determine if a signature guarantee* is required.

* A signature guarantee may be obtained from any eligible guarantor institution, as defined by the Securities and Exchange Commission. These institutions include

banks, saving associations, credit unions and brokerage firms. The words “SIGNATURE GUARANTEED” must be stamped or typed near your signature. The

guarantee must appear with the printed name, title, and signature of an officer and the name of the guarantor institution. Please note that a Notary Public Seal or

Stamp is not acceptable.

Acceptance / Custodian Authorization

U.S. Bank, NA, hereby accepts its appointment as Custodian of the above IRA account and upon receipt of assets, will deposit such

assets in a DoubleLine Funds IRA on behalf of the Depositor authorizing this transfer or direct rollover.

U.S. BANK, NA

For additional information please call toll-free 877-DLINE11 (877-354-6311) or visit us on the web at

10/2013

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