Form 587368 - Wellstrade Customer Account Transfer

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WellsTrade
Customer Account Transfer
Questions 1-800-TRADERS. We're here for you 24/7.
Sub Firm #
Doc Code
Account Number
First Clearing #
Avoid potential delays! Fax or mail with this form with a recent
account statement attached to:
0141
205
WTACAT
Fax: (800)433-0738
(Office Use Only)
Address: 1 N Jefferson Ave, MAC H0004-014, St. Louis, MO 63103
1. WellsTrade Account You Are Transferring Into
2. Account You Are Transferring From
Account Number
Account Number
(Only one account # can be used per form)
Soc Sec Num / Client Tax ID Number
Soc Sec Num Secondary / Tax ID Number
Name of Financial Institution
Account Titling
Account Titling (exactly as it appears on your statement)
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
Owner’s Address
Financial Institution’s Address
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
(select only one)
(select only one)
Non-Retirement Account Type
Non-Retirement Account Type
Single
Joint
Trust
UTMA/UGMA
Estate
Single
Joint
Trust
UTMA/UGMA
Estate
Corporate
Other _______________________
Corporate
Other _______________________
Retirement Account Type (See page 2 for Retirement Account Reminders)
Retirement Account Type (See page 2 for Retirement Account Reminders)
Roth IRA
Traditional IRA
Qualified
Roth IRA
Traditional IRA
Qualified
401(k)
SIMPLE IRA
Other _______________
401(k)
SIMPLE IRA
Other _______________
SEP IRA
Education Savings
SEP IRA
Education Savings
Please note that a statement dated within the last 90 days is REQUIRED for this form to be processed.
3. Transfer Instructions
(select one)
A. Entire Account Transfer
D. Liquidate and Transfer Certificate of Deposit (CD)
Full In Kind – transfer your entire account exactly as it is without selling
Upon Maturity – the maturity date is _________________.
anything. Note: If checked, skip Section 4 – Individual Assets.
(submit 4 weeks before maturity date to process prior to renewal)
Full Liquidation – sell all assets and transfer proceeds as cash.
–or–
Note: If checked, skip Section 4 – Individual Assets.
Immediately – (There may be a penalty and/or surrender charge)
Full Combination (In Kind and Liquidation) – sell only assets listed in
Percent or Amount: __________________
(if percentage not indicated,
Section 4 under Individual Assets and transfer proceeds as cash;
liquidate all.)
transfer remaining assets in kind.
E. Annuity Liquidation (check one only)
B. Transfer Part of My Account (your account will remain open)
Immediately and entirely (There may be a penalty and/or surrender
Only transfer assets or cash proceeds as listed in Section 4 under
charge)
Individual Assets.
–or–
C. Transfer Mutual Funds Purchased Directly from a Mutual Fund
Penalty-free amount only
Company
Percent or Amount: __________________
(if percentage not indicated,
Mutual Funds shares. List each fund in Section 4, Individual Assets.
liquidate all.)
Mutual Fund Certificates. Please see Page 4 for instructions.
4. Individual Assets
Only use this section for partial account transfers, transfers of mutual funds owned directly with a mutual fund company, or to request specific assets to
be sold and the proceeds transferred as cash.
IF NOT
COMPLETED
ASSUMED
Cash $
_____________________________
CHOICE IS
IF NOT COMPLETED ASSUMED
(Cash not applicable for Mutual Funds Company Transfers)
IN-KIND
CHOICE IS REINVEST
Mutual Fund
Mutual Fund
Mutual Fund
Transfers
Asset Description
Capital Gains Option
Dividends Option
Account Number
(Must be checked
Symbol / CUSIP
Quantity
for each asset)
(select one)
(select one)
(if owned directly at the mutual fund company)
All
In-Kind
Reinvest
Reinvest
______________
Sell
Cash
Cash
All
In-Kind
Reinvest
Reinvest
______________
Sell
Cash
Cash
All
In-Kind
Reinvest
Reinvest
______________
Sell
Cash
Cash
All
In-Kind
Reinvest
Reinvest
______________
Sell
Cash
Cash
All
In-Kind
Reinvest
Reinvest
______________
Sell
Cash
Cash
SR#
587368 (Rev 06 – 04/14) Page 1 of 5

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