Tod Transfer Form

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TOD Transfer Form
ICON Capital LLC
To:_
_________________
Transaction Reference Number:
___________________
(GENERAL PARTNER OR TRANSFER AGENT)[SEE INSTRUCTION 1])
(OPTIONAL-SEE INSTRUCTION 2)
PO Box 219476
__
____________
Kansas City, MO 64121-9476
__
________
_______________________________________
The transferee hereby makes application to accept, subject to the general partner's rights, from the transferor all rights and interests, as set forth in the
partnership below, and intends to succeed the transferor as a Substitute Limited Partner or Assignee and agrees to accept all the terms and conditions of
the partnership agreement and related documents.
X
FULL NAME OF PARTNERSHIP
Partnership Information:
X Quantity
Complete at least one of the following (see instruction 3)
Complete both
CUSIP #___________________________________
Number of units
X Do you already
NASD Symbol:______________________________
to be
own units
Partnership Tax ID #:_________________________
acquired:
(check one)
Tax Shelter ID #:____________________________
________
Yes___ No___
X Registration Type
As you want it to appear in the partnership record, for certain types of registration additional documentation may be required (check one).
Taxable Transferee:
___ Individual
___ Taxable Trust
___ Community Property
___ Joint Tenants with Right of Survivorship
___ Estate
___ Taxable Employee Plan
___ Tenants in Common
___ Partnership
___ Other
___ Tenants by the Entirety
___ Custodian Under Uniform Gifts/Transfers to Minors
___ Corporation
Act: State of_____________
Tax Deferred/Exempt Transferee:
___ IRA Account
___ Tax Exempt Trust
___ Money Purchase Pension Plan
___ Direct Transfer Rollover To IRA
___ Tax Exempt Employee Plan
___ Tax Exempt Under IRC 501( c)(3)
___ Simplified Employee Pension Plan (SEP)(Includes KEOGH)
___ Profit Sharing Plan
X Registration Information
Account name and address as it is to appear on registration. If Custodial Account (i.e., IRA, etc.), indicate the Custodian's name followed by the
Beneficial owner's name and Custodian's address, (see instruction 4).
Partnership interests are to be registered as follows:
NAME OF TRANSFEREE(S)
_______________________________________
_________________________________________________
ADDRESS
COUNTRY OF RESIDENCE
_______________________________________
_________________________________________________
STATE OF RESIDENCE/ZIP CODE
_______________________________________
TELEPHONE
CUSTODIAL ACCOUNT # (OPTIONAL) _____________________________________
X (Check one) ___ U.S. Citizen ___ U.S. Resident Alien

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