Common use of Transfer Form Clause in Contracts

Transfer Form. Use this form to transfer funds from your existing HSA to your NuView IRA. Please note that your existing HSA custodian may require a Medallion Guarantee Stamp, which is much like a notary seal. Check with your bank to obtain this stamp. OR Annual Contribution NuView IRA Processing Office 000 X. Xxxxxx Xxxxxx Blvd. Longwood, FL 32750 Contact Us Office: (000) 000-0000 Toll Free: (000) 000-0000 Fax: (000) 000-0000 Email: Xxxxxxxxx@XxXxxxXXX.xxx Web: XxXxxxXxxxx.xxx Discover a new world of investment options. Thank you for your interest in Self-Directing your IRA through NuView IRA, Inc. Please complete the sections below, sign and return with original signatures to our office. To initiate the account, we will need the original completed forms: IRA Account Application IRA Transfer or Direct Rollover Form (if transferring funds) Photocopy of your driver's license (Patriot Act requirement) For office use only: Account No.: Date Received: 1 PERSONAL INFORMATION Legal Name (Required) Mr. Ms. Mrs. Dr. Date of Birth (MM/DD/YYYY) Social Security Number Legal Address (Required) City, State, Zip Mailing Address (Optional) City, State, Zip Primary Phone Fax Mobile Email Address Marital Status Single Married (see Consent of Spouse) Widowed or Divorced Current/Most Recent Occupation (Required) Title 2 NOTIFICATIONS Would you like to receive your quarterly statements online? Yes (no charge) No ($10 annual fee) How did you hear about us? Referral name: Referred by: NuView Client Online via: Realtor CPA Attorney Advisor Other: 3 ACCOUNT TYPE Please select one: Traditional IRA SEP IRA (please attach employer plan documents) Employer Name: SIMPLE IRA (please attach employer plan documents) Employer Name: Xxxx XXX Beneficiary/Inherited IRA Check one: Trad Xxxx SEP SIMPLE ■ Health Savings Account Check one: Self-only coverage Family coverage Original XXX Xxxxxx Name: 4 ACCOUNT FUNDING Annual Contribution Year contribution for: Transfer Contribution Transfer from existing HSA or Employer Sponsored Plan. Rollover Contribution Take receipt of the assets for up to 60 days before reinvesting in a new retirement plan.

Transfer Form. Use this form to transfer funds from your existing HSA to your NuView IRA. Please note that your existing HSA custodian may require a Medallion Guarantee Stamp, which is much like a notary seal. Check with your bank to obtain this stamp. OR Annual Contribution NuView IRA Processing Office 000 X. Xxxxxx Xxxxxx Blvd. Longwood, FL 32750 Contact Us Office: (000) 000-0000 Toll Free: (000) 000-0000 Fax: (000) 000-0000 Email: Xxxxxxxxx@XxXxxxXXX.xxx Email:XXXXxxxxxxxxx@XxxxxxXxxxx.xxx Web: XxXxxxXxxxx.xxx Discover a new world of investment options. Thank you for your interest in Self-Directing your IRA through NuView IRA, Inc. Please complete the sections below, sign and return with original signatures to our office. To initiate the account, we will need the original completed forms: IRA Account Application IRA Transfer or Direct Rollover Form (if transferring funds) Photocopy of your driver's license (Patriot Act requirement) For office use only: Account No.: Date Received: 1 PERSONAL INFORMATION Legal Name (Required) Mr. Ms. Mrs. Dr. Date of Birth (MM/DD/YYYY) Social Security Number Legal Address (Required) City, State, Zip Mailing Address (Optional) City, State, Zip Primary Phone Fax Mobile Email Address Marital Status Single Married (see Consent of Spouse) Widowed or Divorced Current/Most Recent Occupation (Required) Title 2 NOTIFICATIONS Would you like to receive your quarterly statements online? Yes (no charge) No ($10 annual fee) Would you like to receive messages regarding your account from NuView via: Text How did you hear about us? Referral name: Referred by: NuView Client Realtor CPA E-mail Attorney Referral name: Online via: Realtor CPA Attorney ✔ Both Advisor Other: 3 2 NOTIFICATIONS ACCOUNT TYPE Please select one: Traditional IRA SEP IRA (please attach employer plan documents) Employer Name: SIMPLE IRA (please attach employer plan documents) Employer Name: Xxxx XXX Beneficiary/Inherited IRA Check one: Trad Xxxx SEP SIMPLE ■ Health Savings Account Check one: Self-only coverage Family coverage Original XXX Xxxxxx Name: 4 ACCOUNT FUNDING Annual Contribution Year contribution for: Transfer Contribution Transfer from existing HSA or Employer Sponsored Plan. Rollover Contribution Take receipt of the assets for up to 60 days before reinvesting in a new retirement plan.

Transfer Form. Use this form to transfer funds from your existing HSA to your NuView IRA. Please note that your existing HSA custodian may require a Medallion Guarantee Stamp, which is much like a notary seal. Check with your bank to obtain this stamp. OR Annual Contribution NuView IRA Processing Office 000 X. Xxxxxx Xxxxxx Blvd. Longwood, FL 32750 Contact Us Office: (000) 000-0000 Toll Free: (000) 000-0000 Fax: (000) 000-0000 Email: Xxxxxxxxx@XxXxxxXXX.xxx Web: XxXxxxXxxxx.xxx Discover a new world of investment options. Thank you for your interest in Self-Directing your IRA through NuView IRA, Inc. Please complete the sections below, sign and return with original signatures to our office. To initiate the account, we will need the original completed forms: IRA Account Application IRA Transfer or Direct Rollover Form (if transferring funds) Photocopy of your driver's license (Patriot Act requirement) For office use only: Account No.: Date Received: 1 PERSONAL INFORMATION Legal Name (Required) Mr. Ms. Mrs. Dr. Date of Birth (MM/DD/YYYY) Social Security Number Legal Address (Required) City, State, Zip Mailing Address (Optional) City, State, Zip Primary Phone Fax Mobile Email Address Marital Status Single Married (see Consent of Spouse) Widowed or Divorced Current/Most Recent Occupation (Required) Title 2 NOTIFICATIONS Would you like to receive your quarterly statements online? Yes (no charge) No ($10 annual fee) Would you like to receive messages regarding your account from NuView via: Text E-mail ✔ Both How did you hear about us? Referral name: Referred by: NuView Client Online via: Realtor CPA Attorney Advisor Referral name: Online via: Other: 3 ACCOUNT TYPE Please select one: Traditional IRA SEP IRA (please attach employer plan documents) Employer Name: SIMPLE IRA (please attach employer plan documents) Employer Name: Xxxx XXX Beneficiary/Inherited IRA Check one: Trad Xxxx SEP SIMPLE Original XXX Xxxxxx Name: ■ Health Savings Account Check one: Self-only coverage Family coverage Original XXX Xxxxxx Name: 4 ACCOUNT FUNDING Annual Contribution Year contribution for: Transfer Contribution Transfer from existing HSA or Employer Sponsored Plan. Rollover Contribution Take receipt of the assets for up to 60 days before reinvesting in a new retirement plan.

Transfer Form. Use this form to transfer funds from your existing HSA ESA to your NuView IRA. Please note that your existing HSA ESA custodian may require a Medallion Guarantee Stamp, which is much like a notary seal. Check with your bank to obtain this stamp. OR Annual Contribution NuView IRA Processing Office 000 X. Xxxxxx Xxxxxx Blvd. Longwood, FL 32750 Contact Us Office: (000) 000-0000 Toll Free: (000) 000-0000 Fax: (000) 000-0000 Email: Xxxxxxxxx@XxXxxxXXX.xxx Email:XxxXxxxxxxx@XxXxxxXxxxx.xxx Web: XxXxxxXxxxx.xxx Discover a new world of investment options. Thank you for your interest in SelfXxxxxxxxx Educational Savings Account Adoption Agreement 000 X. Xxxxxx Xxxxxx Blvd. Longwood, FL 32750 P: (000) 000-Directing your IRA through NuView IRA, Inc. Please complete the sections below, sign and return with original signatures to our office. To initiate the account, we will need the original completed forms0000 | F: IRA Account Application IRA Transfer or Direct Rollover Form (if transferring funds000) Photocopy of your driver's license (Patriot Act requirement) For office use only000-0000 E: Account No.: Date Received: XxxXxxxxxxx@XxxxxxXxxxx.xxx 1 PERSONAL DEPOSITOR INFORMATION Legal Name (Required) Mr. Ms. Mrs. Dr. Date of Birth (MM/DD/YYYY) Social Security Number Legal Address (Required) City, State, Zip Mailing Address (Optional) City, State, Zip Primary Phone Fax Mobile Phone Email Address Marital Status Single Married 2 BENEFICIARIES Designated Beneficiary Name Social Security Number Relationship Date of Birth Share % Address City State Zip In the event of the Designated Beneficiary's death, the balance shall be paid to the Primary Beneficiaries who survive the Designated Beneficiary in equal shares (see Consent or the specified shares, if indicated). If the Primary or Contingent box is not checked, the beneficiary will be deemed to be a Primary Beneficiary. If an account owner does not designate an account beneficiary, the assets of Spouse) Widowed or Divorced Current/Most Recent Occupation the account will be transferred to the estate upon the account owner's death. Select Beneficiary Type: Primary Contingent Name Social Security Number Relationship Date of Birth Share % Address City State Zip Select Beneficiary Type: Primary Contingent Name Social Security Number Relationship Date of Birth Share % Address City State Zip 3 ACCOUNT FUNDING Initial Contribution Amount Date Contributed Regular Contribution for tax year: Rollover from another Xxxxxxxxx ESA Transfer from another Xxxxxxxxx ESA from: Military Death Gratuity/ SGLI Payments 4 RESPONSIBLE INDIVIDUAL INFORMATION Legal Name (Required) Title 2 NOTIFICATIONS Would you like Mr. Ms. Mrs. Dr. Date of Birth (MM/DD/YYYY) Social Security Number Address City, State, Zip Primary Phone Mobile Phone Email Address The Responsible Individual shall shall not continue to receive your quarterly statements online? Yes serve as the Responsible Individual after the Designated Beneficiary attains the age of majority pursuant to section 5.02 of the Custodial Agreement. The Responsible Individual may may not change the beneficiary designated under this Custodial Agreement pursuant to section 6.01 of the Custodial Agreement. Note: The Responsible Individual may be the Depositor, but generally must be a parent or legal guardian of the Designated Beneficiary. Fee Schedule (no chargeeffective January 1, 2022) No 000 X. Xxxxxx Xxxxxx Blvd. Longwood, FL 32750 P: (000) 000-0000 | F: (000) 000-0000 E: XxxXxxxxxxx@XxxxxxXxxxx.xxx 1 FEE SCHEDULE ANNUAL ACCOUNT FEES $125 Charged upon account opening and annually thereafter Asset Holding Fee for account values >$15k – $325 for each asset upon purchase and annually thereafter, with a maximum asset holding fee of $1,950/annually Asset Holding Fee for account values <$15k – $75 for each asset upon purchase and annually thereafter, with a maximum asset holding fee of $450/annually MISCELLANEOUS FEES Account Establishment: $50 (Paid upon initial application) Returned Items: $25 Overnight Mail: $30 Fair Market Value stale dated asset: $75 (Charged annually) Paper Statement: $10 annual fee(Annually) How did you hear about us? Referral nameTermination Fee: Referred by.005 of account value with a maximum of $250 Wire Fee Domestic: NuView Client Online via$30 Any outside Legal Research and/or Attorney Services and/or Fees will be billed directly to the client (as a pass through cost) at the current billing rate of $350/hour. Special services, such as research of closed accounts, legal research, expedited investment review or additional processing required for certain complex transactions: Realtor CPA Attorney Advisor Other$150/hour PAY FEES BY: 3 ACCOUNT TYPE Please select oneVISA MC AMEX DISCOVER Deduct fees from my undirected cash account CARD NUMBER: Traditional IRA SEP IRA (please attach employer plan documents) Employer NameEXP DATE: SIMPLE IRA (please attach employer plan documents) Employer NameNAME ON CARD: Xxxx XXX Beneficiary/Inherited IRA Check oneBILLING ZIP CODE: Trad Xxxx SEP SIMPLE ■ Health Savings Account Check onePreferred Billing Method: Self-only coverage Family coverage Original XXX Xxxxxx Name: 4 ACCOUNT FUNDING Annual Contribution Year contribution for: Transfer Contribution Transfer from existing HSA or Employer Sponsored Plan. Rollover Contribution Take receipt of the assets for up to 60 days before reinvesting Always charge my credit card Only charge my credit card when there are no cash funds in a new retirement plan.my IRA

Transfer Form. Use this form to transfer funds from your existing HSA to your NuView IRA. Please note that your existing HSA custodian may require a Medallion Guarantee Stamp, which is much like a notary seal. Check with your bank to obtain this stamp. OR Annual Contribution NuView IRA Processing Office 000 X. Xxxxxx Xxxxxx Blvd. Longwood, FL 32750 Contact Us Office: (000) 000-0000 Toll Free: (000) 000-0000 Fax: (000) 000-0000 Email: Xxxxxxxxx@XxXxxxXXX.xxx Email:XxxXxxxxxxx@XxxxxxXxxxx.xxx Web: XxXxxxXxxxx.xxx Discover a new world of investment options. Thank you for your interest in Self-Directing your IRA through NuView IRA, Inc. Please complete the sections below, sign and return with original signatures to our office. To initiate the account, we will need the original completed forms: IRA Account Application IRA Transfer or Direct Rollover Form (if transferring funds) Photocopy of your driver's license (Patriot Act requirement) For office use only: Account No.: Date Received: 1 PERSONAL INFORMATION Legal Name (Required) Mr. Ms. Mrs. Dr. Date of Birth (MM/DD/YYYY) Social Security Number Legal Address (Required) City, State, Zip Mailing Address (Optional) City, State, Zip Primary Phone Fax Mobile Email Address Marital Status Single Married (see Consent of Spouse) Widowed or Divorced Current/Most Recent Occupation (Required) Title 2 NOTIFICATIONS Would you like to receive your quarterly statements online? Yes (no charge) No ($10 annual fee) Would you like to receive messages regarding your account from NuView via: Text How did you hear about us? Referral name: Referred by: NuView Client Realtor CPA E-mail Attorney Referral name: Online via: Realtor CPA Attorney ✔ Both Advisor Other: 3 2 NOTIFICATIONS ACCOUNT TYPE Please select one: Traditional IRA SEP IRA (please attach employer plan documents) Employer Name: SIMPLE IRA (please attach employer plan documents) Employer Name: Xxxx XXX Beneficiary/Inherited IRA Check one: Trad Xxxx SEP SIMPLE ■ Health Savings Account Check one: Self-only coverage Family coverage Original XXX Xxxxxx Name: 4 ACCOUNT FUNDING Annual Contribution Year contribution for: Transfer Contribution Transfer from existing HSA or Employer Sponsored Plan. Rollover Contribution Take receipt of the assets for up to 60 days before reinvesting in a new retirement plan.

Transfer Form. Use this form to transfer funds from your existing HSA to your NuView IRA. Please note that your existing HSA custodian may require a Medallion Guarantee Stamp, which is much like a notary seal. Check with your bank to obtain this stamp. OR Annual Contribution NuView IRA Processing Office 000 X. Xxxxxx Xxxxxx Blvd. Longwood, FL 32750 Contact Us Office: (000) 000-0000 Toll Free: (000) 000-0000 Fax: (000) 000-0000 Email: Xxxxxxxxx@XxXxxxXXX.xxx Web: XxXxxxXxxxx.xxx Discover a new world of investment options. Thank you for your interest in Self-Directing your IRA through NuView IRA, Inc. Please complete the sections below, sign and return with original signatures to our office. To initiate the account, we will need the original completed forms: IRA Account Application IRA Transfer or Direct Rollover Form (if transferring funds) Photocopy of your driver's license (Patriot Act requirement) For office use only: Account No.: Date Received: 1 PERSONAL INFORMATION Legal Name (Required) Mr. Ms. Mrs. Dr. Date of Birth (MM/DD/YYYY) Social Security Number Legal Address (Required) City, State, Zip Mailing Address (Optional) City, State, Zip Primary Phone Fax Mobile Email Address Marital Status Single Married (see Consent of Spouse) Widowed or Divorced Current/Most Recent Occupation (Required) Title 2 NOTIFICATIONS Would you like to receive your quarterly statements online? Yes (no charge) No ($10 annual fee) Would you like to receive messages regarding your account from NuView via: Text How did you hear about us? Referral name: Referred by: NuView Client Realtor CPA E-mail Attorney Referral name: Online via: Realtor CPA Attorney ✔ Both Advisor Other: 2 NOTIFICATIONS 3 ACCOUNT TYPE Please select one: Traditional IRA SEP IRA (please attach employer plan documents) Employer Name: SIMPLE IRA (please attach employer plan documents) Employer Name: Xxxx XXX Beneficiary/Inherited IRA Check one: Trad Xxxx SEP SIMPLE ■ Health Savings Account Check one: Self-only coverage Family coverage Original XXX Xxxxxx Name: 4 ACCOUNT FUNDING Annual Contribution Year contribution for: Transfer Contribution Transfer from existing HSA or Employer Sponsored Plan. Rollover Contribution Take receipt of the assets for up to 60 days before reinvesting in a new retirement plan.