Simplified Purchase Application & Agreement

Investments Held in Trust Only

Please attach copy of trust cover page, successor trustee provisions and trust signature page
Name
Date of Trust

MonthDayYear
Date
Tax ID Number (if different from owner's social)
Name and Date of Trust

What investment do you want?

Investment Types and Terms
Investment Type*
Time Certificate - Investment Term
Promotional Certificate
How much would you like to Invest?
Total Investment? *
Distribution of Interest

Accumulate and compound in my investmentPay to me quarterly by electronic funds transfer
Comments

0/500
Recurring Transfers
What day would you like your monthly contribution withdrawn from your bank account?

5th of the month20th of the month
Investment Term Formatted
Investment Period Formatted
Investment Type Formatted

What bank account do you want to use to transfer funds to CDF Capital?

Electronic Funds Transfer
Bank Name*
Bank Routing Number*
Checking or Savings Account*

CheckingSavings
Bank Account Number*
Re-enter Bank Account Number*
*Account numbers entered do not match. Please try again.
Account Number full
ETF Date Number
Total Investment amount number
Additional Contribution Number

Who will be the beneficiary of this investment?

Distribution upon Death
Select from below the primary beneficiary upon death for this investment*

My estateThe following Individual or institutionCDF Capital
Name
Relationship
Address line 1
Address line 2
City
State
Zip Code
Phone Number
Please enter a valid phone number.
Should be Empty: