United Development Funding IV Account Transfer Form

Transcription

1 United Development Funding United Development Funding Toll-Free SECTION 1 - TRANSFER FROM THE FOLLOWING ACCOUNT (Must complete for all transfers) UDF Account Number Name(s) on the Account $ or Unit Amount (or ALL ) SECTION 2 - TRANSFER TO AN EXISTING UDF ACCOUNT OR IN-HOUSE TRANSFER (IF THIS APPLIES, skip Sections 3and 4, and resume with Section 5) UDF Account Number Name(s) on the Account SECTION 3 NEW FORM OF OWNERSHIP (IF THIS APPLIES, you must complete all Sections 3 through 8) Non-Custodial Ownership INDIVIDUAL OR JOINT TENANT (with rights of survivorship) TRANSFER ON DEATH (Optional designation of beneficiaries for individuals, joint owners with rights of survivorship. Please complete Section 4E.) TENANTS IN COMMON COMMUNITY PROPERTY UNIFORM GIFT/TRANSFER TO MINORS (UGMA/UTMA) Under the UGMA/UTMA of the State of. PENSION PLAN (Include trust documents naming the trust and authorized trustees) TRUST (Include trust documents naming the trust and authorized trustees/successor trustees) CORPORATION OR PARTNERSHIP (Include Corporate Resolution or Partnership Agreement naming authorized signatories) Brokerage Account # (if applicable)_ Custodial Ownership THIRD PARTY ADMINISTERED CUSTODIAN PLAN IRA Roth IRA Sep IRA Simple Other Name of Custodian Mailing Address City State Zip_ Custodian Information (To be completed by Custodian) Custodian Tax ID # Custodian Account # Custodian Phone # OTHER (Include title and signature pages) 1 of 5

2 Toll-Free SECTION 4 NEW INVESTOR INFORMATION (Please print name(s) in which shares are to be registered) A. Investor/Trustee First Name MI Last Name Gender Date of Birth (MM/DD/YYYY) B. Co-Investor/Trustee (if applicable) First Name MI Last Name Gender Date of Birth (MM/DD/YYYY) C. Residential Street Address (Must be completed for verification purposes if address in Sec 4A is a P.O. Box) D. Trust/Corporation/Partnership/Other (Trustee(s) information must be provided in Sections 4A & 4B) Entity Name Tax ID Number Date of Establishment E. Transfer on Death Beneficiary Information (for individual/joint accts only) per stirpes per capita Provide additional page with same details, if you have more beneficiaries than the space allotted. 2 of 5

3 Toll-Free SECTION 5 - DISTRIBUTIONS (Select only one) Complete this section to enroll in the Dividend Reinvestment Plan, to elect to receive dividend distributions by check mailed to you at the above address, to elect to receive dividend distributions by check mailed to a third-party or alternate address, or to elect to receive dividend distributions by direct deposit. For Custodial held accounts, if you elect cash distributions the funds will be directed back to the Custodian (Select Option C). I hereby subscribe for Shares/Units and elect the distribution option indicated below. A. Reinvest/Dividend Reinvestment Plan B. Check (mailed to the address set forth in Section 4A) C. Check Mailed to Third Party / Alternate Address / Custodian Name/Entity Name/Financial Institution Account Number D. Direct Deposit (Please attach a pre-printed voided check or instructions from financial institution for savings or brokerage accounts. Non-Custodian investors only.) Name/Entity Name/Financial Institution Account Number SECTION 6 COST BASIS REPORTING Effective January 1, 2011, new federal income tax information reporting rules may apply to certain transactions in our shares. Where they apply, the cost basis calculated for the shares involved will be reported to the Internal Revenue Service ( IRS ) and to you. Generally these rules apply to all shares purchased after December 31, 2010, including those purchased through our distribution reinvestment plan. You should consult your own tax advisor regarding the consequences of these new rules and your cost basis reporting options. A. Indicate the type of transfer being affected by this form (Please select only one option): Account Re-Registration Gift Inheritance Secondary Market Transaction Price Paid per share by Transferee: $ (required) 5 of 5

4 Toll-Free SECTION 7 BROKER-DEALER / FINANCIAL ADVISOR INFORMATION _ Broker Dealer Name Financial Advisor Name _ Advisor Number Branch Number _ Advisor _ Address Telephone Number Fax Number _ Financial Advisor Signature Date SECTION 8 SUITABILITY STANDARDS FOR TRANSFEREE - Please read carefully and separately initial each of the representation below. I have (i) a net worth (exclusive of home, furnishings and automobiles) of $250,000 or more; or (ii) a net worth (exclusive of home, furnishings and automobiles) of at least $70,000 and had during the last tax year or estimate that I will have during the current tax year a minimum of $70,000 annual gross income, or I meet the higher suitability requirements imposed by my state of primary residence as set forth in the Prospectus under Suitability Standards. Owner Joint Owner If I am a California, Kentucky, Missouri, Ohio, Oregon or Pennsylvania resident, this investment does not exceed 10% of my liquid net worth, as set forth in the Prospectus. If I am an Alabama or Iowa resident, this investment, when added to my investments in similar programs, does not exceed 10% of my liquid net worth, as set forth in the Prospectus. If I am a Michigan or Ohio resident, this investment, when added to my investments in affiliates of the Fund, does not exceed 10% of my liquid net worth, as set forth in the Prospectus. If I am a resident of Kansas or Massachusetts, I acknowledge the recommendation of the Kansas Office of the Securities Commissioner or the Massachusetts Securities Division that I should limit my aggregate investment in the Fund and other similar investments to not more than 10% of my liquid net worth (for purposes of the recommendation of the Kansas Office of Securities Commissioner, liquid net worth is defined as that portion of total net worth that consists of cash, cash equivalents, and readily marketable securities.) Owner Joint Owner 4 of 5

5 Toll-Free SECTION 9 AUTHORIZATION AND SIGNATURE OF TRANSFEROR (All signatures must be Medallion Signature Guaranteed) TAXPAYER IDENTIFICATION NUMBER OR SOCIAL SECURITY NUMBER CONFIRMATION (required): The investor signing below, under penalties of perjury, certifies that (i) the number shown on this subscription agreement is my correct taxpayer identification number (or I am waitownering for a number to be issued to me), (ii) I am not subject to backup withholding because I am exempt from backup withholding, I have not been notified by the Internal Revenue Service ( IRS ) that I am subject to backup withholding, and (iii) I am a U.S. person (including a U.S. resident alien). Signature of Current Investor/Trustee Date Signature of Current Co-Investor/Trustee (if applicable) Authorized Agent s Signature for Current Custodian (if applicable) (Please be sure to include a Corporate Resolution reflecting the authorized signor s signature) SECTION 10 AUTHORIZATION AND SIGNATURE OF TRANSFEREE (All registered owners must sign, and all signatures must be Medallion Signature Guaranteed) Signature of New Investor/Trustee_ Date Signature of New Co-Investor/Trustee (if applicable) Authorized Agent s Signature for Current Custodian (if applicable) (Please be sure to include a Corporate Resolution reflecting the authorized signor s signature) 5 of 5