Incoming/Outgoing Transfer Form

Use this form to transfer assets between your current broker and DriveWealth, LLC.
Please submit this form and a copy of your account statement dated within the last 90 days to ensure proper handling and processing of your transfer. Account titles and Tax Identification Number(s) must match.

Delivering Account Information

Receiving Account Information

Transfer Type – Indicate your preference below. Please note, fractional shares cannot be transferred; you will need to work with the delivering/receiving firm to resolve any partial positions before initiating your transfer request.

__ Full ACAT Transfer – Transfer all securities and cash
__ Partial ACAT Transfer – Transfer only securities/cash specified below
__ DRS Transfer
__ DTC Free of Payment (FOP) Transfer (must be DTC code 40)
__ DWAC Transfer

$ Cash Amount: ___________________________

Mutual Funds – Complete this section only if you hold mutual funds directly with a mutual fund company rather than in your existing brokerage account.

If a mutual fund cannot be held at DriveWealth, your signature at the end of this form gives authorization to the Delivering Firm to liquidate the position and transfer the cash in a manner which you will arrange with the Delivering Firm before initiating your transfer request.

Signatures

All DriveWealth account holders/custodians/trustees must sign below. By signing this form, you acknowledge you have carefully read, understood, and agreed to the provisions of this document as well as its terms and conditions. You certify the information provided by you on this form is true. Your signature(s) authorize(s) DriveWealth to process the transfer of your assets between your current firm and DriveWealth, LLC.

Account Owner Signature / Date ___________________________

Co-Account Owner Signature / Date ___________________________

Terms & Conditions

All DriveWealth account holders/custodians/trustees agree as follows:

• If my DriveWealth account is a qualified retirement account, I have amended the applicable plan so that it designates DriveWealth, LLC as successor custodian. If my DriveWealth account is an Individual Retirement Account (IRA), I have adopted an IRA plan so that it names DriveWealth, LLC as successor custodian.

• Unless otherwise indicated in the instructions above, please transfer, in-kind, all assets into my account with DriveWealth, LLC. I understand that to the extent any assets in my account are not readily transferable, with or without any penalties, such assets may not be transferred within the timeframes required by applicable regulations. I understand that I will be contacted by DriveWealth, LLC with regard to any assets that are not transferable. As fractional shares of stock are not transferable, any and all fractional shares held at the Delivering Firm will be liquidated upon the transfer of the whole shares.

• Unless otherwise indicated in the instructions above, I authorize you to liquidate any nontransferable proprietary money market fund assets that are part of my account and transfer the resulting credit balance to the successor custodian. I authorize the Delivering Firm to deduct any outstanding fees due to transfer from the credit balance, or if the credit balance in my account is insufficient to satisfy any outstanding fees due to you, I authorize you to liquidate the assets in my account to the extent necessary to satisfy such obligation.

• If certificates or other instruments in my account are in the Delivering Firm’s possession, I instruct the Delivering Firm to transfer them in food deliverable form, including affixing any necessary tax waivers, to enable the successor custodian to transfer them in its name for the purpose of sale, when and as directed by me.

• I understand that upon receiving a copy of this transfer instruction, for a full account transfer, the Delivering Firm will freeze my account and cancel all open orders. I understand that no new orders may/will be taken.

• If the assets I am transferring are considered non-standard assets at DriveWealth, LLC, I realize I may be charged a set-up and/or maintenance fee for such positions.

Letter of Acceptance (must be requested by delivering firm if needed)

DriveWealth, LLC is approved by the Internal Revenue Service (IRS) to act as a non-bank custodian. DriveWealth, LLC agrees to serve as the successor custodian for the account of the above-named individual and agrees to accept the assets being transferred.

DriveWealth Representative Name / Signature / Date ___________________________

DriveWealth Instructions (if needed by delivering firm)