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.
