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PRIMARY DEATH BENEFICIARY DESIGNATION The following is hereby designated as the beneiciary in the case of death of the above-designated beneiciary Date of Birth MM-DD-YYYY Relationship to Account Owner 3. SIGNATURE The undersigned responsible individual hereby states that all previous designation s of death beneiciary ies with respect to the above-designated ESA are hereby revoked. The responsible individual understands that this change of designated death beneiciary will be efective on the date of receipt by TD Ameritrade and that upon any change of beneiciary the right of all previously designated beneiciaries to receive beneit under this account shall cease. PO Box 2760 Omaha NE 68103-2760 Coverdell Education Savings Account ESA Change of Designated Death Bene ciary Form Fax 866-468-6268 1. DESIGNATED BENEFICIARY STUDENT INFORMATION Name Preix optional M Mr. M Mrs. M Ms. M Dr. M Rev* Full Legal Name Phone Number U*S* Social Security Number SSN Street Address no PO box or mail drop City State ZIP Code 2. PRIMARY DEATH BENEFICIARY DESIGNATION The following is hereby designated as the beneiciary in the case of death of the above-designated beneiciary Date of Birth MM-DD-YYYY Relationship to Account Owner 3. SIGNATURE The undersigned responsible individual hereby states that all previous designation s of death beneiciary ies with respect to the above-designated ESA are hereby revoked* The responsible individual understands that this change of designated death beneiciary will be efective on the date of receipt by TD Ameritrade and that upon any change of beneiciary the right of all previously designated beneiciaries to receive beneit under this account shall cease. The responsible individual retains the right to revoke this designation of death beneiciary and to designate a new death beneiciary at any time by written communication to TD Ameritrade Inc* 200 South 108th Avenue Omaha NE 68154-2631. Signature of Responsible Individual Date Original signature required electronic signatures and/or signature fonts are not authorized* Investment Products Not FDIC Insured No Bank Guarantee May Lose Value TD Ameritrade Inc* member FINRA/SIPC/NFA and TD Ameritrade Clearing Inc* member FINRA/SIPC. PO Box 2760 Omaha NE 68103-2760 Coverdell Education Savings Account ESA Change of Designated Death Bene ciary Form Fax 866-468-6268 1. DESIGNATED BENEFICIARY STUDENT INFORMATION Name Preix optional M Mr. M Mrs. M Ms. M Dr. M Rev* Full Legal Name Phone Number U*S* Social Security Number SSN Street Address no PO box or mail drop City State ZIP Code 2. DESIGNATED BENEFICIARY STUDENT INFORMATION Name Preix optional M Mr. M Mrs. M Ms. M Dr. M Rev* Full Legal Name Phone Number U*S* Social Security Number SSN Street Address no PO box or mail drop City State ZIP Code 2. PRIMARY DEATH BENEFICIARY DESIGNATION The following is hereby designated as the beneiciary in the case of death of the above-designated beneiciary Date of Birth MM-DD-YYYY Relationship to Account Owner 3.

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