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A UGMA Age of Termination Date Gift Was Given / / Manner In Which Gift Was Given: Trust Exercise by Appointment Will Transfer by Fiduciary or Obligor Created by Gift 2. MINOR INFORMATION (THE ACCOUNTHOLDER) NAME (FIRST) (MIDDLE) (LAST) LEGAL ADDRESS (NO P.O. BOXES) CITY, STATE, ZIP CODE MAILING ADDRESS (IF DIFFERENT FROM ABOVE; P.O. BOXES MAY BE USED) CITY, STATE, ZIP CODE DATE OF BIRTH (MM/DD/YYYY) HOME TELEPHONE NUMBER CELL PHONE NUMBER ( SOCIAL SECURITY/TAX ID NUM.

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