MAIL ADDRESS. Duplicate Statement #1 Complete only if you wish someone other than the account owner(s) to receive duplicate statements. Duplicate Statement #2 Complete only if you wish someone other than the account owner(s) to receive duplicate statements. COMPANY NAME COMPANY NAME NAME NAME STREET APT / SUITE STREET APT / SUITE CITY STATE ZIP CODE CITY STATE ZIP CODE 4 Investment Amount By check: Make check payable to the Xxxxx Small Cap Growth Fund. Note: All checks must be in U.S. Dollars drawn on a domestic bank. The Fund will not accept payment in cash or money orders. The Fund does not accept post dated checks or any conditional order or payment. To prevent check fraud, the Fund will not accept third party checks, Treasury checks, credit card checks, traveler’s checks or starter checks for the purchase of shares. By wire: Call 000-000-0000. Note: A completed application is required in advance of a wire. By transfer: Due to rollover or beneficiary payout. Note: Completion of XXX Transfer Form or Beneficiary Payout Form is required. Investment Amount $2,000 Minimum Xxxxx Small Cap Growth Fund 7005 $ Page 2 of 5 5 Automatic Investment Plan (AIP) Your signed Application must be received at least 15 calendar days prior to initial transaction. If you choose this option, funds will be automatically transferred from your bank account. Please attach a voided check or savings deposit slip to Section 7 of this application. We are unable to debit mutual fund or pass-through (“for further credit”) accounts. Draw money for my AIP (check one): Monthly Quarterly $100 minimum monthly, $300 quarterly If no option is selected, the frequency will default to monthly. Xxxxx Small Cap Growth Fund AMOUNT PER DRAW AIP START MONTH AIP START DAY Please keep in mind that: • There is a fee if the automatic purchase cannot be made (assessed by redeeming shares from your account). • Participation in the plan will be terminated upon redemption of all shares. • An AIP will cease the year in which a shareholder reaches the age of 70 1/2 (excluding SEP, SIMPLE and Xxxx XXX accounts). • All contributions invested using Automatic Investment Plan will be current year contributions.
Appears in 2 contracts
Samples: Custodial Account Agreement, Custodial Account Agreement
MAIL ADDRESS. ❑ Duplicate Statement #1 Complete only if you wish someone other than the account owner(s) to receive duplicate statements. ❑ Duplicate Statement #2 Complete only if you wish someone other than the account owner(s) to receive duplicate statements. COMPANY NAME COMPANY NAME NAME NAME STREET APT / SUITE STREET APT / SUITE CITY STATE ZIP CODE CITY STATE ZIP CODE 4 Investment Amount ❑ By check: Make check payable to the Xxxxx Small Cap Growth Fund. Note: All checks must be in U.S. Dollars drawn on a domestic bank. The Fund will not accept payment in cash or money orders. The Fund does not accept post dated checks or any conditional order or payment. To prevent check fraud, the Fund will not accept third party checks, Treasury checks, credit card checks, traveler’s checks or starter checks for the purchase of shares. ❑ By wire: Call 000-000-0000. Note: A completed application is required in advance of a wire. ❑ By transfer: Due to rollover or beneficiary payout. Note: Completion of XXX Transfer Form or Beneficiary Payout Form is required. Investment Amount $2,000 Minimum ❑ Xxxxx Small Cap Growth Fund 7005 Inv. Class 7006 $ Page 2 of 5 5 Automatic Investment Plan (AIP) Your signed Application must be received at least 15 calendar days prior to initial transaction. If you choose this option, funds will be automatically transferred from your bank account. Please attach a voided check or savings deposit slip to Section 7 6 of this application. We are unable to debit mutual fund or pass-through (“for further credit”) accounts. Draw money for my AIP (check one): ❑ Monthly ❑ Quarterly $100 minimum monthly, $300 quarterly ❑ Xxxxx Small Cap Growth Fund Inv. Class Please keep in mind that: If no option is selected, the frequency will default to monthly. Xxxxx Small Cap Growth Fund AMOUNT PER DRAW AIP START MONTH AIP START DAY Please keep in mind that: • There is a fee if the automatic purchase cannot be made (assessed by redeeming shares from your account). • Participation in the plan will be terminated upon redemption of all shares. • An AIP will cease the year in which a shareholder reaches the age of 70 1/2 (excluding SEP, SIMPLE and Xxxx XXX accounts). Xxxx Xxx Xxxx Xxx 000 Xxxx Xx. Xxxxxxx, XXX 00000 53289 Pay to the order of $ DOLLARS Memo Signed Please attach a voided check or savings deposit slip to this application if you chose the Automatic Investment Plan. We are unable to debit or credit mutual fund or pass-through (“for further credit”) accounts. Please contact your financial institution to determine if it participates in the Automated Clearing House system (ACH). VOID • All contributions invested using Automatic Investment Plan will be current year contributions. 6 Voided Check for Bank Information 7 Beneficiary Information | If you need more space, please enclose a separate sheet of paper. Primary NAME ❑ Spouse ❑ Non Spouse ❑ Spouse ❑ Non Spouse ❑ Spouse ❑ Non Spouse SOCIAL SECURITY NUMBER DATE OF BIRTH % NAME SOCIAL SECURITY NUMBER DATE OF BIRTH % NAME Secondary SOCIAL SECURITY NUMBER DATE OF BIRTH % NAME ❑ Spouse ❑ Non Spouse ❑ Spouse ❑ Non Spouse ❑ Spouse ❑ Non Spouse SOCIAL SECURITY NUMBER DATE OF BIRTH % NAME SOCIAL SECURITY NUMBER DATE OF BIRTH % NAME SOCIAL SECURITY NUMBER DATE OF BIRTH % Spousal Consent: If you name someone other than or in addition to your spouse as primary beneficiary and reside in a community or marital property state, including AZ, CA, ID, LA, NV, NM, TX, WA, and WI, your spouse must consent by signing below. SIGNATURE OF SPOUSE DATE X 8 Signature ✔I have read and understand the Disclosure Statement and Custodial Account Agreement. I adopt the Xxxxx Small Cap Growth Fund Custodial Account Agreement, as it may be revised from time to time, and appoint the Custodian or its agent to perform those functions and appropriate administrative services specified. I have received and understand the prospectus for the Xxxxx Small Cap Growth Fund (the “Fund”). I understand the Fund’s objectives and policies and agree to be bound by the terms of the prospectus. Before I request an exchange, I will obtain the current prospectus for each Fund. I acknowledge and consent to the householding (i.e., consolidation of mailings) of regulatory documents such as prospectuses, shareholder reports, proxy statements, and other similar documents. I may contact the Fund to revoke my consent. I agree to notify the Fund of any errors or discrepancies within 45 days after the date of the statement confirming a transaction. The statement will be deemed to be correct, and the Fund and its transfer agent shall not be liable, if I fail to notify the Fund within such time period. I certify that I am of legal age and have the legal capacity to make this purchase. [If the Grantor is a minor under the laws of the Grantor’s state of residence, a parent or guardian must sign the XXX Application (i.e., “Xxxxx Xxx, parent of Xxxx Xxx”). Until the Grantor reaches the age of majority, the parent or guardian will exercise the duties of the Grantor. (If not a parent, the guardian must provide a copy of the letters of appointment.)] ✔If I am opening a Traditional XXX with a distribution from an employer-sponsored retirement plan, I elect to treat the distribution as a partial or total distribution and certify that the distribution qualifies as a rollover contribution. I understand that the fees relating to my account may be collected by redeeming sufficient shares. The custodian may change the fee schedule at any time. ✔I understand that my mutual fund account assets may be transferred to my state of residence if no activity occurs within my account during the inactivity period specified in my State’s abandoned property laws. ✔The Fund, its transfer agent, and any of their respective agents or affiliates will not be responsible for banking system delays beyond their control. By completing Sections 5, I authorize my bank to honor all entries to my bank account initiated through U.S. Bank NA, on behalf of the applicable Fund. The Fund, its transfer agent, and any of their respective agents or affiliates will not be liable for acting upon instructions believed to be genuine and in accordance with the procedures described in the prospectus or the rules of the Automated Clearing House. When AIP or Telephone Purchase transactions are presented, sufficient funds must be in my account to pay them. I agree that my bank’s treatment and rights to respect each entry shall be the same as if it were signed by me personally. I agree that if any such entries are not honored with good or sufficient cause, my bank shall be under no liability whatsoever. I further agree that any such authorization, unless previously terminated by my bank in writing, is to remain in effect until the Fund’s transfer agent receives and has had reasonable amount of time to act upon a written notice of revocation. X DEPOSITOR / LEGALLY RESPONSIBLE INDIVIDUAL’S SIGNATURE Appointment as Custodian accepted: U.S. BANK, NA DATE (MM/DD/YYYY) 9 SIMPLE XXX Plans Only Employer Information: EMPLOYER (COMPANY) NAME XXXXXXXX XXXXXX XXXXXXX XXXXXXXX XXXX / XXXXX / XXX CODE EMPLOYER CONTACT NAME EMPLOYER CONTACT BUSINESS PHONE 10 Dealer Information DEALER NAME REPRESENTATIVE’S LAST NAME FIRST NAME M.I. DEALER’S ID BRANCH ID DEALER HEAD OFFICE INFORMATION: REPRESENTATIVE’S ID REPRESENTATIVE BRANCH OFFICE INFORMATION: ADDRESS ADDRESS CODE CITY / STATE / ZIP CITY / STATE / ZIP TELEPHONE NUMBER TELEPHONE NUMBER Before you mail, have you: ! ❑ Completed all USA PATRIOT Act required information? – Social Security or Tax ID Number in Section 2? – Birth Date in Section 2? – Full Name in Section 2? – Permanent street address in Section 3? ❑ Enclosed your check made payable to Xxxxx Small Cap Growth Fund? ❑ Included a voided check, if applicable? ❑ Signed your application in Section 8? For additional information please call toll-free 000-000-0000 or visit us on the web at xxxxxxxxxx.xxx. 7/2016 Page 5 of 5 Xxxxx Small Cap Growth Fund XXX Transfer Form [If this is for a new XXX Account, an XXX Application must accompany this form.] Mail to: Xxxxx Small Cap Growth Fund c/o U.S. Bancorp Fund Services, LLC XX Xxx 000 ! Xxxxxxxxx, XX 00000-0000 Overnight Express Mail To: Xxxxx Small Cap Growth Fund c/o U.S. Bancorp Fund Services, LLC 000 X. Xxxxxxxx Xx., XX0 Xxxxxxxxx, XX 00000-0000 There may be penalties for withdrawing certain investments before their maturity (i.e., certificates of deposit or annuities). Please contact your current custodian or plan administrator prior to submitting this form to determine the applicable time frames and penalties, if any, or if you need a signature guarantee in Section Six to order this transfer. U.S. Bancorp Fund Services, LLC will initiate your request upon receipt of this form. 1 Investor Information FIRST NAME M.I. LAST NAME SOCIAL SECURITY XXXXXX XXXXXXX XXXX / XXXXX / XXX XXXXXXX PHONE NUMBER EVENING PHONE NUMBER 2 Instructions to Current XXX Custodian or Plan Administrator Please include a copy of your current account statement. CURRENT CUSTODIAN OR PLAN ADMINISTRATOR FUND NAME, IF APPLICABLE ACCOUNT NUMBER CONTACT PERSON CONTACT NUMBER
Appears in 1 contract
Samples: Custodial Account Agreement
MAIL ADDRESS. Duplicate Statement #1 Complete only if you wish someone other than the account owner(s) to receive duplicate statements. Duplicate Statement #2 Complete only if you wish someone other than the account owner(s) to receive duplicate statements. COMPANY NAME COMPANY NAME NAME NAME STREET APT / SUITE STREET APT / SUITE CITY STATE ZIP CODE CITY STATE ZIP CODE 4 Investment Amount By check: Make check payable to the Xxxxx Small Cap Growth Fund. Note: All checks must be in U.S. Dollars drawn on a domestic bank. The Fund will not accept payment in cash or money orders. The Fund does not accept post dated checks or any conditional order or payment. To prevent check fraud, the Fund will not accept third party checks, Treasury checks, credit card checks, traveler’s checks or starter checks for the purchase of shares. By wire: Call 000-000-0000. Note: A completed application is required in advance of a wire. By transfer: Due to rollover or beneficiary payout. Note: Completion of XXX Transfer Form or Beneficiary Payout Form is required. Investment Amount $2,000 Minimum Xxxxx Small Cap Growth Fund 7005 $ Page 2 of 5 5 Automatic Investment Plan (AIP) Your signed Application must be received at least 15 calendar up to 7 business days prior to initial transaction. If you choose this option, funds will be automatically transferred from your bank account. Please attach a voided check or savings deposit slip to Section 7 of this application. We are unable to debit mutual fund or pass-through (“for further credit”) accounts. Draw money for my AIP (check one): Monthly Quarterly $100 minimum monthly, $300 quarterly If no option is selected, the frequency will default to monthly. Xxxxx Small Cap Growth Fund AMOUNT PER DRAW AIP START MONTH AIP START DAY Please keep in mind that: • There is a fee if the automatic purchase cannot be made (assessed by redeeming shares from your account). • Participation in the plan will be terminated upon redemption of all shares. • An AIP will cease the year in which a shareholder reaches the age of 70 1/2 (excluding SEP, SIMPLE and Xxxx XXX accounts). • All contributions invested using Automatic Investment Plan will be current year contributions.
Appears in 1 contract
Samples: Custodial Account Agreement
MAIL ADDRESS. Duplicate Statement #1 Complete only if you wish someone other than the account owner(s) to receive duplicate statements. Duplicate Statement #2 Complete only if you wish someone other than the account owner(s) to receive duplicate statements. COMPANY NAME COMPANY NAME NAME NAME STREET APT / SUITE STREET APT / SUITE CITY STATE ZIP CODE CITY STATE ZIP CODE 4 Investment Amount By check: Make check payable to the Xxxxx Small Cap Growth Fund. Note: All checks must be in U.S. Dollars drawn on a domestic bank. The Fund will not accept payment in cash or money orders. The Fund does not accept post dated checks or any conditional order or payment. To prevent check fraud, the Fund will not accept third party checks, Treasury checks, credit card checks, traveler’s checks or starter checks for the purchase of shares. By wire: Call 000-000-0000. Note: A completed application is required in advance of a wire. By transfer: Due to rollover or beneficiary payout. Note: Completion of XXX Transfer Form or Beneficiary Payout Form is required. Investment Amount $2,000 Minimum Xxxxx Small Cap Growth Fund 7005 $ Page 2 of 5 5 Automatic Investment Plan (AIP) Your signed Application must be received at least 15 calendar days prior to initial transaction. If you choose this option, funds will be automatically transferred from your bank account. Please attach a voided check or savings deposit slip to Section 7 6 of this application. We are unable to debit mutual fund or pass-through (“for further credit”) accounts. Draw money for my AIP (check one): Monthly Quarterly $100 minimum monthly, $300 quarterly If no option is selected, the frequency will default to monthly. Xxxxx Small Cap Growth Fund AMOUNT PER DRAW AIP START MONTH AIP START DAY Please keep in mind that: • There is a fee if the automatic purchase cannot be made (assessed by redeeming shares from your account). • Participation in the plan will be terminated upon redemption of all shares. • An AIP will cease the year in which a shareholder reaches the age of 70 1/2 (excluding SEP, SIMPLE and Xxxx XXX accounts). • All contributions invested using Automatic Investment Plan will be current year contributions. 6 Voided Check for Bank Information Xxxx Xxx Xxxx Xxx 000 Xxxx Xx. Xxxxxxx, XXX 00000 53289 Pay to the order of $ DOLLARS Memo Signed Please attach a voided check or savings deposit slip to this application if you chose the Automatic Investment Plan. We are unable to debit or credit mutual fund or pass-through (“for further credit”) accounts. Please contact your financial institution to determine if it participates in the Automated Clearing House system (ACH). VOID 7 Beneficiary Information | If you need more space, please enclose a separate sheet of paper. Primary NAME Spouse Non Spouse Spouse Non Spouse Spouse Non Spouse SOCIAL SECURITY NUMBER DATE OF BIRTH % NAME SOCIAL SECURITY NUMBER DATE OF BIRTH % NAME Secondary SOCIAL SECURITY NUMBER DATE OF BIRTH % NAME Spouse Non Spouse Spouse Non Spouse Spouse Non Spouse SOCIAL SECURITY NUMBER DATE OF BIRTH % NAME SOCIAL SECURITY NUMBER DATE OF BIRTH % NAME SOCIAL SECURITY NUMBER DATE OF BIRTH % Spousal Consent: If you name someone other than or in addition to your spouse as primary beneficiary and reside in a community or marital property state, including AZ, CA, ID, LA, NV, NM, TX, WA, and WI, your spouse must consent by signing below. SIGNATURE OF SPOUSE DATE X 8 Signature I have read and understand the Disclosure Statement and Custodial Account Agreement. I adopt the Xxxxx Small Cap Growth Fund Custodial Account Agreement, as it may be revised from time to time, and appoint the Custodian or its agent to perform those functions and appropriate administrative services specified. I have received and understand the prospectus for the Xxxxx Small Cap Growth Fund (the “Fund”). I understand the Fund’s objectives and policies and agree to be bound by the terms of the prospectus. Before I request an exchange, I will obtain the current prospectus for each Fund. I acknowledge and consent to the householding (i.e., consolidation of mailings) of regulatory documents such as prospectuses, shareholder reports, proxy statements, and other similar documents. I may contact the Fund to revoke my consent. I agree to notify the Fund of any errors or discrepancies within 45 days after the date of the statement confirming a transaction. The statement will be deemed to be correct, and the Fund and its transfer agent shall not be liable, if I fail to notify the Fund within such time period. I certify that I am of legal age and have the legal capacity to make this purchase. [If the Grantor is a minor under the laws of the Grantor’s state of residence, a parent or guardian must sign the XXX Application (i.e., “Xxxxx Xxx, parent of Xxxx Xxx”). Until the Grantor reaches the age of majority, the parent or guardian will exercise the duties of the Grantor. (If not a parent, the guardian must provide a copy of the letters of appointment.)] If I am opening a Traditional XXX with a distribution from an employer-sponsored retirement plan, I elect to treat the distribution as a partial or total distribution and certify that the distribution qualifies as a rollover contribution. I understand that the fees relating to my account may be collected by redeeming sufficient shares. The custodian may change the fee schedule at any time. I understand that my mutual fund account assets may be transferred to my state of residence if no activity occurs within my account during the inactivity period specified in my State’s abandoned property laws. The Fund, its transfer agent, and any of their respective agents or affiliates will not be responsible for banking system delays beyond their control. By completing the banking sections of this application, I authorize my bank to honor all entries to my bank account initiated through U.S. Bank NA, on behalf of the applicable Fund. The Fund, its transfer agent, and any of their respective agents or affiliates will not be liable for acting upon instructions believed to be genuine and in accordance with the procedures described in the prospectus or the rules of the Automated Clearing House. When AIP or Telephone Purchase transactions are presented, sufficient funds must be in my account to pay them. I agree that my bank’s treatment and rights to respect each entry shall be the same as if it were signed by me personally. I agree that if any such entries are not honored with good or sufficient cause, my bank shall be under no liability whatsoever. I further agree that any such authorization, unless previously terminated by my bank in writing, is to remain in effect until the Fund’s transfer agent receives and has had reasonable amount of time to act upon a written notice of revocation. X DEPOSITOR / LEGALLY RESPONSIBLE INDIVIDUAL’S SIGNATURE Appointment as Custodian accepted: U.S. BANK, NA DATE (MM/DD/YYYY) 9 SIMPLE XXX Plans Only Employer Information: EMPLOYER (COMPANY) NAME XXXXXXXX XXXXXX XXXXXXX XXXXXXXX XXXX / XXXXX / XXX CODE EMPLOYER CONTACT NAME EMPLOYER CONTACT BUSINESS PHONE 10 Dealer Information DEALER NAME REPRESENTATIVE’S LAST NAME FIRST NAME M.I. DEALER’S ID BRANCH ID DEALER HEAD OFFICE INFORMATION: REPRESENTATIVE’S ID REPRESENTATIVE BRANCH OFFICE INFORMATION: ADDRESS ADDRESS CODE CITY / STATE / ZIP CITY / STATE / ZIP TELEPHONE NUMBER TELEPHONE NUMBER Before you mail, have you: ! Completed all USA PATRIOT Act required information? – Social Security or Tax ID Number in Section 2? – Birth Date in Section 2? – Full Name in Section 2? – Permanent street address in Section 3? Enclosed your check made payable to Xxxxx Small Cap Growth Fund? Included a voided check, if applicable? Signed your application in Section 8? For additional information please call toll-free 000-000-0000 or visit us on the web at xxxxxxxxxx.xxx. 7/2016 Page 5 of 5 Privacy Policy The privacy of your personal financial information is extremely important to us. When you open an account with us, we collect a significant amount of information from you in order to properly invest and administer your account. We take very seriously the obligation to keep that information private and confidential, and we want you to know how we protect that important information. We collect nonpublic personal information about you from applications or other forms you complete and from your transactions with us or our affiliates. We do not disclose information about you, or our former clients, to our affiliates or to service providers or other third parties, except as permitted by law. We share only the information required to properly administer your accounts, which enables us to send transaction confirma- tions, monthly or quarterly statements, financials and tax forms. Even within RBB Fund, Inc. and its affiliated entities, a limited number of people who actually service accounts will have access to your personal financial information. Further, we do not share information about our current or former clients with any outside marketing groups or sales entities. To ensure the highest degree of security and confidentiality, RBB Fund, Inc. and its affiliates maintain various physical, electronic and procedural safeguards to protect your personal information. We also apply special measures for authentication of information you request or submit to us on our web site. If you have questions or comments about our privacy practices, please call us at 0-000-000-0000. Xxxxx Small Cap Growth Fund XXX Transfer Form [If this is for a new XXX Account, an XXX Application must accompany this form.] Mail to: Xxxxx Small Cap Growth Fund c/o U.S. Bancorp Fund Services, LLC XX Xxx 000 ! Xxxxxxxxx, XX 00000-0000 Overnight Express Mail To: Xxxxx Small Cap Growth Fund c/o U.S. Bancorp Fund Services, LLC 000 X. Xxxxxxxx Xx., XX0 Xxxxxxxxx, XX 00000-0000 There may be penalties for withdrawing certain investments before their maturity (i.e., certificates of deposit or annuities). Please contact your current custodian or plan administrator prior to submitting this form to determine the applicable time frames and penalties, if any, or if you need a signature guarantee in Section Six to order this transfer. U.S. Bancorp Fund Services, LLC will initiate your request upon receipt of this form. 1 Investor Information FIRST NAME M.I. LAST NAME SOCIAL SECURITY XXXXXX XXXXXXX XXXX / XXXXX / XXX XXXXXXX PHONE NUMBER EVENING PHONE NUMBER 2 Instructions to Current XXX Custodian or Plan Administrator Please include a copy of your current account statement. CURRENT CUSTODIAN OR PLAN ADMINISTRATOR FUND NAME, IF APPLICABLE ACCOUNT NUMBER CONTACT PERSON CONTACT NUMBER
Appears in 1 contract
Samples: Custodial Account Agreement
MAIL ADDRESS. ❑ Duplicate Statement #1 Complete only if you wish someone other than the account owner(s) to receive duplicate statements. ❑ Duplicate Statement #2 Complete only if you wish someone other than the account owner(s) to receive duplicate statements. COMPANY NAME COMPANY NAME NAME NAME STREET APT / SUITE STREET APT / SUITE CITY STATE ZIP CODE CITY STATE ZIP CODE 4 Investment Amount ❑ By check: Make check payable to the Xxxxx Small Cap Growth Fund. Note: All checks must be in U.S. Dollars drawn on a domestic bank. The Fund will not accept payment in cash or money orders. The Fund does not accept post dated checks or any conditional order or payment. To prevent check fraud, the Fund will not accept third party checks, Treasury checks, credit card checks, traveler’s checks or starter checks for the purchase of shares. ❑ By wire: Call 000-000-0000. Note: A completed application is required in advance of a wire. ❑ By transfer: Due to rollover or beneficiary payout. Note: Completion of XXX Transfer Form or Beneficiary Payout Form is required. Investment Amount $2,000 Minimum ❑ Xxxxx Small Cap Growth Fund 7005 Inv. Class 7006 $ Page 2 of 5 5 Automatic Investment Plan (AIP) Your signed Application must be received at least 15 calendar days prior to initial transaction. If you choose this option, funds will be automatically transferred from your bank account. Please attach a voided check or savings deposit slip to Section 7 6 of this application. We are unable to debit mutual fund or pass-through (“for further credit”) accounts. Draw money for my AIP (check one): ❑ Monthly ❑ Quarterly $100 minimum monthly, $300 quarterly ❑ Xxxxx Small Cap Growth Fund Inv. Class Please keep in mind that: If no option is selected, the frequency will default to monthly. Xxxxx Small Cap Growth Fund AMOUNT PER DRAW AIP START MONTH AIP START DAY Please keep in mind that: • There is a fee if the automatic purchase cannot be made (assessed by redeeming shares from your account). • Participation in the plan will be terminated upon redemption of all shares. • An AIP will cease the year in which a shareholder reaches the age of 70 1/2 (excluding SEP, SIMPLE and Xxxx XXX accounts). Xxxx Xxx Xxxx Xxx 000 Xxxx Xx. Xxxxxxx, XXX 00000 53289 Pay to the order of $ DOLLARS Memo Signed Please attach a voided check or savings deposit slip to this application if you chose the Automatic Investment Plan. We are unable to debit or credit mutual fund or pass-through (“for further credit”) accounts. Please contact your financial institution to determine if it participates in the Automated Clearing House system (ACH). VOID • All contributions invested using Automatic Investment Plan will be current year contributions. 6 Voided Check for Bank Information 7 Beneficiary Information | If you need more space, please enclose a separate sheet of paper. Primary NAME ❑ Spouse ❑ Non Spouse ❑ Spouse ❑ Non Spouse ❑ Spouse ❑ Non Spouse SOCIAL SECURITY NUMBER DATE OF BIRTH % NAME SOCIAL SECURITY NUMBER DATE OF BIRTH % NAME Secondary SOCIAL SECURITY NUMBER DATE OF BIRTH % NAME ❑ Spouse ❑ Non Spouse ❑ Spouse ❑ Non Spouse ❑ Spouse ❑ Non Spouse SOCIAL SECURITY NUMBER DATE OF BIRTH % NAME SOCIAL SECURITY NUMBER DATE OF BIRTH % NAME SOCIAL SECURITY NUMBER DATE OF BIRTH % Spousal Consent: If you name someone other than or in addition to your spouse as primary beneficiary and reside in a community or marital property state, including AZ, CA, ID, LA, NV, NM, TX, WA, and WI, your spouse must consent by signing below. SIGNATURE OF SPOUSE DATE X 8 Signature ✔I have read and understand the Disclosure Statement and Custodial Account Agreement. I adopt the Xxxxx Small Cap Growth Fund Custodial Account Agreement, as it may be revised from time to time, and appoint the Custodian or its agent to perform those functions and appropriate administrative services specified. I have received and understand the prospectus for the Xxxxx Small Cap Growth Fund (the “Fund”). I understand the Fund’s objectives and policies and agree to be bound by the terms of the prospectus. Before I request an exchange, I will obtain the current prospectus for each Fund. I acknowledge and consent to the householding (i.e., consolidation of mailings) of regulatory documents such as prospectuses, shareholder reports, proxy statements, and other similar documents. I may contact the Fund to revoke my consent. I agree to notify the Fund of any errors or discrepancies within 45 days after the date of the statement confirming a transaction. The statement will be deemed to be correct, and the Fund and its transfer agent shall not be liable, if I fail to notify the Fund within such time period. I certify that I am of legal age and have the legal capacity to make this purchase. [If the Grantor is a minor under the laws of the Grantor’s state of residence, a parent or guardian must sign the XXX Application (i.e., “Xxxxx Xxx, parent of Xxxx Xxx”). Until the Grantor reaches the age of majority, the parent or guardian will exercise the duties of the Grantor. (If not a parent, the guardian must provide a copy of the letters of appointment.)] ✔If I am opening a Traditional XXX with a distribution from an employer-sponsored retirement plan, I elect to treat the distribution as a partial or total distribution and certify that the distribution qualifies as a rollover contribution. I understand that the fees relating to my account may be collected by redeeming sufficient shares. The custodian may change the fee schedule at any time. ✔I understand that my mutual fund account assets may be transferred to my state of residence if no activity occurs within my account during the inactivity period specified in my State’s abandoned property laws. ✔The Fund, its transfer agent, and any of their respective agents or affiliates will not be responsible for banking system delays beyond their control. By completing the banking sections of this application, I authorize my bank to honor all entries to my bank account initiated through U.S. Bank NA, on behalf of the applicable Fund. The Fund, its transfer agent, and any of their respective agents or affiliates will not be liable for acting upon instructions believed to be genuine and in accordance with the procedures described in the prospectus or the rules of the Automated Clearing House. When AIP or Telephone Purchase transactions are presented, sufficient funds must be in my account to pay them. I agree that my bank’s treatment and rights to respect each entry shall be the same as if it were signed by me personally. I agree that if any such entries are not honored with good or sufficient cause, my bank shall be under no liability whatsoever. I further agree that any such authorization, unless previously terminated by my bank in writing, is to remain in effect until the Fund’s transfer agent receives and has had reasonable amount of time to act upon a written notice of revocation. X DEPOSITOR / LEGALLY RESPONSIBLE INDIVIDUAL’S SIGNATURE Appointment as Custodian accepted: U.S. BANK, NA DATE (MM/DD/YYYY) 9 SIMPLE XXX Plans Only Employer Information: EMPLOYER (COMPANY) NAME XXXXXXXX XXXXXX XXXXXXX XXXXXXXX XXXX / XXXXX / XXX CODE EMPLOYER CONTACT NAME EMPLOYER CONTACT BUSINESS PHONE 10 Dealer Information DEALER NAME REPRESENTATIVE’S LAST NAME FIRST NAME M.I. DEALER’S ID BRANCH ID DEALER HEAD OFFICE INFORMATION: REPRESENTATIVE’S ID REPRESENTATIVE BRANCH OFFICE INFORMATION: ADDRESS ADDRESS CODE CITY / STATE / ZIP CITY / STATE / ZIP TELEPHONE NUMBER TELEPHONE NUMBER Before you mail, have you: ! ❑ Completed all USA PATRIOT Act required information? – Social Security or Tax ID Number in Section 2? – Birth Date in Section 2? – Full Name in Section 2? – Permanent street address in Section 3? ❑ Enclosed your check made payable to Xxxxx Small Cap Growth Fund? ❑ Included a voided check, if applicable? ❑ Signed your application in Section 8? For additional information please call toll-free 000-000-0000 or visit us on the web at xxxxxxxxxx.xxx. 7/2016 Page 5 of 5 Xxxxx Small Cap Growth Fund XXX Transfer Form [If this is for a new XXX Account, an XXX Application must accompany this form.] Mail to: Xxxxx Small Cap Growth Fund c/o U.S. Bancorp Fund Services, LLC XX Xxx 000 ! Xxxxxxxxx, XX 00000-0000 Overnight Express Mail To: Xxxxx Small Cap Growth Fund c/o U.S. Bancorp Fund Services, LLC 000 X. Xxxxxxxx Xx., XX0 Xxxxxxxxx, XX 00000-0000 There may be penalties for withdrawing certain investments before their maturity (i.e., certificates of deposit or annuities). Please contact your current custodian or plan administrator prior to submitting this form to determine the applicable time frames and penalties, if any, or if you need a signature guarantee in Section Six to order this transfer. U.S. Bancorp Fund Services, LLC will initiate your request upon receipt of this form. 1 Investor Information FIRST NAME M.I. LAST NAME SOCIAL SECURITY XXXXXX XXXXXXX XXXX / XXXXX / XXX XXXXXXX PHONE NUMBER EVENING PHONE NUMBER 2 Instructions to Current XXX Custodian or Plan Administrator Please include a copy of your current account statement. CURRENT CUSTODIAN OR PLAN ADMINISTRATOR FUND NAME, IF APPLICABLE ACCOUNT NUMBER CONTACT PERSON CONTACT NUMBER
Appears in 1 contract
Samples: Custodial Account Agreement
MAIL ADDRESS. ❑ Duplicate Statement #1 Complete only if you wish someone other than the account owner(s) to receive duplicate statements. ❑ Duplicate Statement #2 Complete only if you wish someone other than the account owner(s) to receive duplicate statements. COMPANY NAME COMPANY NAME NAME NAME STREET APT / SUITE STREET APT / SUITE CITY STATE ZIP CODE CITY STATE ZIP CODE 4 Investment Amount ❑ By check: Make check payable to the Xxxxx Small Cap Growth Fund. Note: All checks must be in U.S. Dollars drawn on a domestic bank. The Fund will not accept payment in cash or money orders. The Fund does not accept post dated checks or any conditional order or payment. To prevent check fraud, the Fund will not accept third party checks, Treasury checks, credit card checks, traveler’s checks or starter checks for the purchase of shares. ❑ By wire: Call 000-000-0000. Note: A completed application is required in advance of a wire. ❑ By transfer: Due to rollover or beneficiary payout. Note: Completion of XXX Transfer Form or Beneficiary Payout Form is required. Investment Amount $2,000 Minimum ❑ Xxxxx Small Cap Growth Fund 7005 $ Page 2 of 5 5 Automatic Investment Plan (AIP) Your signed Application must be received at least 15 calendar up to 7 business days prior to initial transaction. If you choose this option, funds will be automatically transferred from your bank account. Please attach a voided check or savings deposit slip to Section 7 of this application. We are unable to debit mutual fund or pass-through (“for further credit”) accounts. Draw money for my AIP (check one): ❑ Monthly ❑ Quarterly $100 minimum monthly, $300 quarterly If no option is selected, the frequency will default to monthly. ❑ Xxxxx Small Cap Growth Fund AMOUNT PER DRAW AIP START MONTH AIP START DAY Please keep in mind that: • There is a fee if the automatic purchase cannot be made (assessed by redeeming shares from your account). • Participation in the plan will be terminated upon redemption of all shares. • An AIP will cease the year in which a shareholder reaches the age of 70 1/2 (excluding SEP, SIMPLE and Xxxx XXX accounts). • All contributions invested using Automatic Investment Plan will be current year contributions.
Appears in 1 contract
Samples: Custodial Account Agreement
