STOCK PLAN TRANSFER REQUEST FORM - Merrill Lynch

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´╗┐General Fax Number: 1-866-650-0003 From Outside the US: +1-678-624-6950

Fax Number of Sender:

(Required)

Customer Name(s):

(Required - Last Name, First Name)

Account Number:

(Required - 8 digits for brokerage accounts, 10 digits for bank accounts)

Number of Pages:

(Required - Including this cover sheet)

Date of Fax Transmission

(Required - MM/DD/YY)

Reference Number:

(Optional - 14 digit number provided by an E*TRADE Customer Service Representative)

Reference Number:

(Optional - 14 digit number provided by an E*TRADE Customer Service Representative)

Reference Number:

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FAX COVER SHEET

IMPORTANT REMINDER: When submitting identifying documentation (i.e. Drivers License, Passport, Military or Government Issued ID), please attempt to enlarge the image by 200% and lighten the copy by two shades. This will aid in efficiently processing your request.

E*TRADE Financial is a registered trademark and the E*TRADE Financial logo is a trademark of E*TRADE Financial Corporation.

? 2011 E*TRADE FINANCIAL Corp. All rights reserved.

1111-FAXCOVER-P61860

E*TRADE Securities, LLC P.O. Box 484 Jersey City, NJ 07303-0484 General Fax Number: 1-866-650-0003 From Outside the US: +1-678-624-6950

STOCK PLAN TRANSFER REQUEST FORM

Use this form to request a transfer of shares from your Employee Stock Plan Account

Please include a Cover Sheet when submitting documents by facsimile

Need Help? Send us a secure message through or call 1-800-838-0908 or 1-650-599-0125 from outside the U.S. (24 hours a day, Monday ? Friday)

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Your E*TRADE Securities Brokerage Account Number

IMPORTANT NOTE Please review these items prior to completing this form to ensure that your request is received in good order and processed correctly.

All sections should be completed in entirety unless otherwise noted or indicated as optional This form is not to be used for 3rd Party transfers. This form may only be utilized to transfer shares between accounts with matching

registrations A specific share quantity is required. `ALL SHARES' is not a valid quantity and will cause the transfer request to be rejected Section 3B: Retail Shares ? Retail Shares are not held in your Employee Stock Plan Portfolio. Retail shares are only available for those

customers that have activated a Retail account, also known as a Complete account, in connection with an Employee Stock Plan account

PRIMARY ACCOUNT HOLDER Name/Account Title

Section 1 : ACCOUNT HOLDER INFORMATION

CO-ACCOUNT HOLDER, IF APPLICABLE Name/Account Title

Section 2 : TRANSFER INSTRUCTIONS (Please complete only one option)

Option A : TO TRANSFER STOCK TO AN ACCOUNT WITH ANOTHER U.S. BROKERAGE FIRM, COMPLETE THIS SECTION

Receiving Firm Name (required)

Merrill Lynch

Receiving Firm DTC Number (required)

5198

Receiving Account Title (required)

Receiving Account Number (required)

Option B : TO TRANSFER STOCK TO AN ACCOUNT WITH AN INTERNATIONAL BROKERAGE FIRM, COMPLETE THIS SECTION

Receiving Firm Name (required)

Receiving Firm DTC Number (required)

Receiving Account Title (required)

Receiving Account Number (required)

Receiving Firm Email Address (required*)

Receiving Firm Phone Number (optional)

* An email address for the Receiving Firm must be provided for the proper processing of an International Transfer

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EXERCISED SHARES

Grant Type

Symbol

Section 3 : SHARE INFORMATION

Option A : TO TRANSFER EMPLOYEE STOCK PLAN SHARES, COMPLETE THIS SECTION

Stock Plan shares consist of Exercised, Employee Stock Purchase Plan, Restricted, and Performance Shares

Grant Date

Grant Number

Number of Shares (Specific Quantity Required) Exercise Date

Exercise Price

EMPLOYEE STOCK PURCHASE PLAN SHARES

Symbol

Number of Shares (Specific Quantity Required)

Purchase Date

Purchase Price

RESTRICTED STOCK/PERFORMANCE SHARES

Grant Type

Grant Date

Symbol

Number of Shares (Specific Quantity Required) Vest Date

Grant Number Cost Basis

*If additional space is needed to list additional lots of Exercised Shares, Employee Stock Purchase Plan Shares, Restricted Stock and/or Performance Shares, please attach a signed letter of instruction including all details requested above, for each additional item listed.

Symbol

Option B : TO TRANSFER RETAIL SHARES, COMPLETE THIS SECTION

Retail shares are not included in your Employee Stock Plan Portfolio. Retail shares are held in your Complete Brokerage Account, if applicable

Number of Shares (Specific Quantity Required)

Symbol

Number of Shares (Specific Quantity Required)

*Specific tax lot selection is not available for Retail shares at this time

ACCOUNT HOLDER SIGNATURES

I authorize E*TRADE Securities LLC to transfer the securities listed above. I understand that upon receiving this form, E*TRADE Securities will cancel any open orders that will affect the transfer. I am aware that the processing of this request is contingent upon the requested shares being deemed freely available for transfer. Shares from Employee Stock Plan accounts must be fully vested and previously delivered from the Employer's Transfer Agent in order to be available for transfer. Requests that contain incomplete information or securities that are deemed unavailable will not be processed.

Signature of Primary Account Holder

Date

Signature of Co-Account Holder

Date

Please print your name here

Please print your name here

The E*TRADE Financial family of companies provides financial services including trading, investing and related banking products and services to retail investors. E*TRADE Securities accounts are carried by E*TRADE Clearing LLC, Member FINRA/SIPC. Securities products and services are offered by E*TRADE Securities LLC, Member FINRA/SIPC. E*TRADE Securities and E*TRADE Clearing and are separate but affiliated companies.

? 2013 E*TRADE Financial Corporation. All rights reserved. E*TRADE Financial is a registered trademark and the E*TRADE Financial logo is a trademark of E*TRADE Financial Corporation.

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