Third Party Trading Form For Td Ameritrade Self-Directed Brokerage Accounts (Page 2 of 2) in pdf

Indemnification

The Plan participant and authorized agent(s) agree to indemnify and hold harmless Colorado PERA, including Colorado PERA’s

Trustees, officers, employees, directors, and agents, from and against all claims, actions, costs, and liabilities, including but not limited

to attorneys’ fees arising out of or relating to any of the participant’s and/or the authorized agent(s) acts or omissions related to the

SDBA or the participant’s and/or the authorized agent(s) use of the SDBA.

Dispute Resolution

The Plan participant and the authorized agent(s) agree and consent to personal jurisdiction and service of process and venue in any

federal or State court within the State of Colorado having subject matter jurisdiction for the purposes of any action, suit, or proceeding

arising out of or relating to this form. Any controversy or claim that arises between Colorado PERA and the Plan participant and/or

the authorized agent(s) will be governed by, and construed, in accordance with the laws of the State of Colorado.

Authorization

By our signatures below, the Plan participant, authorized agent(s), and Colorado PERA agree to the provisions within this document

in its entirety, and attest that this authorization supersedes any other authorization or document that the participant and authorized

agent may execute or may have executed relating to the SDBA.

Plan Participant

Participant Name ______________________________________________________

Partcipant Signature ____________________________________________________ Date

⁄

________

_ _______

Authorized Agent

Authorized Agent Name __________________________________________________

Authorized Agent Signature _______________________________________________ Date

⁄

________

_ _______

To be Completed by Colorado PERA

Sponsor Name_________________________________________________________

⁄

Sponsor Signature ______________________________________________________ Date

________

_ _______

Third Party Trading Form For Td Ameritrade Self-Directed Brokerage Accounts Page 2