tokens
sequence
bboxes
sequence
[ "403(b)(7)", "CUSTODIAN", "ADOPTION", "AGREEMENT", "ACCOUNT", "INFORMATION", "(This", "Adoption", "Agreement", "may", "only", "be", "used", "in", "conjunction", "with", "the", "403(b)(7)", "C", "ustodial", "Account", "Agreement", "stipulated", "(If", "you", "are", "not", "sure", "ift", "this", "account", "is", "subject", "to", "the", "terms", "of", "ERISA,", "ask", "your", "employer.", "Ifchecked,", "you", "must", "submit", "a", "separate", "Beneficiary", "Designation", "Form", "in", "by", "the", "C", "Custodian.)", "Ift", "this", "account", "is", "subject", "to", "the", "terms", "of", "the", "Employee", "Retirement", "Income", "Security", "Act", "of", "1974", "(ERISA),", "check", "here:", "addition", "to", "this", "Adoption", "Agreement.)", "as", "the", "financial", "organization", "II.", "PARTICIPANT", "INFORMATION", "NAME:Enter", "Name>", "MAILING", "ADDRESS:", "TELEPHONE:", "III.", "EMPLOYER", "INFORMATION", "EMPLOYER", "NAME:", "EMPLOYER", "MAILING", "ADDRESS:", "EMPLOYER", "TELEPHONE:", "Ihereby", "designate", "Independent", "Financial", "Group", "LLC", "ACCOUNT", "NUMBER:", "OFFICE", "RR", "GENDER:", "M", "F", "DATE", "OF", "BIRTH:", "SOCIAL", "SECURITY", "NUMBER:", "CITY:", "STATE:", "ZIP:", "CITY:", "STATE:", "ZIP:", "IV.", "The", "Participant", "authorizes", "any", "uninvested", "cash", "in", "the", "Account", "tol", "be", "invested", "in", "shares", "ofa", "money", "market", "of", "a", "regulated", "investment", "company", "as", "further", "described", "in", "the", "403(b)(7)", "Custodial", "Account", "Agreement.", "Any", "such", "investment", "of", "idle", "cash", "is", "made", "pursuant", "to", "a", "prospectus", "or", "other", "offering", "document,", "which", "the", "For", "more", "complete", "information", "about", "the", "money", "market", "fund,", "including", "charges", "and", "expenses,", "request", "a", "prospectus", "from", "your", "financial", "organization.", "Read", "it", "Participant", "should", "obtain", "from", "his", "or", "her", "financial", "organization.", "carefully", "before", "you", "invest.", "BENEFICIARY", "This", "section", "is", "for", "non-ERISA", "accounts", "only.", "ERISA", "Participants", "must", "complete", "a", "separate", "Beneficiary", "Designation", "Form.", "MARITAL", "STATUS:", "L", "Single", "Married", "(NOTE:", "Spousal", "consent", "may", "be", "required.", "See", "below.)", "Note:", "For", "specific", "beneficiary", "provisions,", "please", "refer", "to", "the", "applicable", "sections", "of", "the", "Custodial", "Account", "Agreement.", "The", "following", "shall", "be", "my", "Beneficiary", "or", "Beneficiaries", "of", "this", "account.", "IfI", "designate", "than", "one", "primary", "or", "contingent", "Beneficiary,", "but", "do", "not", "specify", "the", "percentages", "to", "which", "such", "Beneficiary", "or", "Beneficiaries", "are", "entitled,", "payment", "will", "be", "made", "to", "the", "surviving", "Beneficiary", "or", "Beneficiaries", "in", "equal", "shares.", "PRIMARY", "BENEFICIARIES", "GENDER", "DATEOF", "SOCIAL", "SECURITY", "NAME", "M/F", "RELATIONSHIP", "BIRTH", "NUMBER", "ADDRESS", "PERCENTAGE", "CONTINGENT", "BENEFICIARIES", "(Secondary", "Beneficiaries", "will", "be", "paid", "only", "if", "all", "primary", "Beneficiaries", "do", "not", "survive", "the", "Participant.)", "GENDER", "DATE", "OF", "SOCIAL", "NAME", "M/F", "RELATIONSHIP", "BIRTH", "NUMBER", "ADDRESS", "PERCENTAGE", "Pershing", "LLC,", "a", "subsidiary", "of", "The", "Bank", "of", "New", "York", "Mellon", "Corporation.", "Member", "FINRA,", "NYSE,", "SIPC.", "Trademark(s)", "belong", "to", "their", "respective", "owners.", "ADOP", "ORPB-403B7-ADOP-11-11", "02010", "Ascensus,", "Inc.,", "Brainerd,", "MN", "#1201", "(11/11)", "Page", "16", "of", "18" ]
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