Star One Credit Union
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Redemption Authorization Form

Do not use this form for IRAs or any sponsored retirement plans.

Complete, print, sign, and mail both pages of this form to Star One Credit Union, PO Box 3643, Sunnyvale, CA 94088-3643. Attn: Support Services.

1. Your Brokerage Account Information

Brokerage Company
Registration
Address City
State Zip Phone


2. Request to Sell Shares

     
Check One
Fund Name
Fund Number
Amount
Shares
Dollars
All

3. Your Information

Name Social Security Number
Address City
State Zip Daytime Phone


Payment Instructions

Make check payable "Star One Credit Union FBO John Smith, Member Number XXXXXXXXX-X" and mail check to: Star One Credit Union, PO Box 3643, Sunnyvale, CA 94088-3643, Attn: Support Services. Phone (408) 543-5202 or (866) 543-5202. Please reference my Star One Member Number .

Wire proceeds to my account. I have attached a voided check. Star One's Routing/Transit Number: 321177968. Star One Member Number .

4. Signature(s) and Signature Guarantee(s)

___________________________________________ _______________________
Signature

Date

___________________________________________ _______________________
Signature Date

 

AFFIX GUARANTEE STAMP(S) HERE
Signature guarantee stamp must not be dated.

 
 


Signatures must be guaranteed by an eligible bank, broker, dealer, credit union, national securities exchange, registered securities association, clearing agency, or a savings association. A notary public is NOT an acceptable guarantor. The guarantee must be in the form of a stamp or a type written or handwritten guarantee that is accompanied by a raised corporate seal.

If you are acting on behalf of the owner, please choose the appropriate capacity in which you are acting. If not listed, please check "Other" and specify your capacity.

Attorney-in-fact* Custodian
Conservator* Alternate Payee/Beneficiary
Executor(trix)* Former Minor
Surviving Tenant Trustee*
Other (please specify)

 

*Please ensure supporting legal documents of authority are provided to the brokerage or attached to this request. 

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