AUTHORIZATION TO WIRE FUNDS This form…

                              AUTHORIZATION TO WIRE FUNDS
This form serves as a Letter of Authorization to wire cash from your Scottrade account to a bank or other financial institution.


                                                        SCOTTRADE ACCOUNT INFORMATION
  SCOTTRADE ACCOUNT NUMBER                                                                 ACCOUNT TITLE / REGISTRATION


  SOCIAL SECURITY OR TAX ID NUMBER                                                         TELEPHONE NUMBER


  REQUESTED BY                                                                             DATE


  REASON FOR THE REQUEST



                                                        FINANCIAL INSTITUTION INFORMATION
  NAME OF RECEIVING BANK OR FINANCIAL INSTITUTION                                          RECEIVING BANK'S ABA ROUTING NUMBER


  CITY AND STATE                                                                           RECIPIENT'S ACCOUNT NUMBER AT THE BANK OR FINANCIAL INSTITUTION


  RECIPIENT'S ACCOUNT NAME AT BANK OR FINANCIAL INSTITUTION


  DESCRIBE YOUR RELATIONSHIP TO RECIPIENT



                                                       FOR FURTHER CREDIT TO (If Applicable)
  ACCOUNT NAME                                                                             ACCOUNT NUMBER



                                                                  AMOUNT OF WIRE TRANSFER

                                                        $                      .           OR                  ALL AVAILABLE CASH



                                                                  DATE TO BE SENT



A $20.00 fee applies to domestic wire transfers, and a $40.00 fee applies to international wire transfers.

Scottrade reserves the right to request additional verification prior to processing a wire transfer request.

Signature of Account Holders:
(If this transfer results in a change of beneficial ownership of transferred assets, such as wiring cash from a joint account at Scottrade to an individual account
at a bank, all Scottrade account holders must sign.)


X                                                                                           X
              ACCOUNT HOLDER'S SIGNATURE                                DATE                               ACCOUNT HOLDER'S SIGNATURE                        DATE




                                                                          SCOTTRADE USE ONLY

                                                   Verified by:


                                                   Title:




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