Form 590757 - Stock Or Bond Power
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Clear
Stock or Bond Power
Account Number
Sub Firm #
Account Number
(Client to complete-Required)
205
(Office Use Only)
IMPORTANT: READ CAREFULLY – The signature(s) to this power must correspond with the name(s) as written upon the face of the
certificate(s) or bond(s). If the signature does not match the registration on the face of the certificate the signer must disclose their
capacity in which they are signing.
FOR Deposit into street name, the undersigned does (do) hereby sell, assign and transfer:
Stock Description:
________________________________________________________________________________
If Stock,
Class:
Number of Shares:
(Common, PFD, Class A) ____________________
_______________________________
Complete
This Portion.
Certificate No(s):
_________________________________________________________________________________
Inclusive standing in the name of the undersigned on the books of said Company.
OR
Bond Description:
________________________________________________________________________________
If Bonds,
Complete
Principal Amount $
, Certificate No(s):
___________________________
________________________________
This Portion.
Inclusive standing in the name of the undersigned on the books of said Company.
CLIENT AUTHORIZATION AND CAPACITY IS REQUIRED IF NOT SIGNED BY CURRENT REGISTERED OWNER
The undersigned does (do) hereby irrevocably constitute and appoint our clearing agent, First Clearing, LLC attorney to transfer
the said stocks or bond(s), as the case may be, on the books of said company, with the full power of substitution in the
premises.
Capacity must be typed or written in same ink as signature; blue ink preferred.
Signature of current owner & Capacity, if applicable
Print Name
Date
X
Capacity (examples: Executor, Trustee, Survivor, Custodian, Heir)
Signature of current owner & Capacity, if applicable
Print Name
Date
X
Capacity (examples: Executor, Trustee, Survivor, Custodian, Heir)
Return Original Completed Document along with the Certificate(s) to:
Physical Processing
Mail Code: H0006-094
1 North Jefferson, St. Louis, MO 63103
For questions please contact 1-800-TRADERS.
Investment and Insurance Products:
Not Insured by FDIC or any Federal Government Agency May Lose Value Not a Deposit of or Guaranteed by a Bank or Any Bank Affiliate
Wells Fargo Advisors, LLC is a registered broker-dealer and separate non-bank affiliate of Wells Fargo & Company
590757 (Rev 03 – 12/13)
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