Transfer of Ownership Package

Everything you need to transfer stock ownership

NEW STREAMLINED PROCEDURE FOR TRANSFERS OF $10,000 OR LESS: Medallion Signature
Guarantee Waiver

• Transfers of shares with aggregate value of $10,000 or less are eligible for waiver from the
requirement for a Medallion Signature Guarantee. To request such waiver, please submit your transfer
paperwork, processing fee of $50 in the form a check payable to American Stock Transfer & Trust
Company, LLC, AND copy of a valid government issued photo identification with a signature, such as a
driver’s license or a passport.
INFORMATION ON ALL REQUIRED DOCUMENTS
• Required documents for all types of transfers. WHAT’S INSIDE
• Additional documents for specific transfer types. Locate your type
of ownership in the tables for any additional documentation that may be Transfer Requirements
required.
• Submit your transfer request to AST at: FAQs
AST
Attention: Transfer Department Checklist
6201 15th Avenue
Brooklyn, NY 11219
As with any transfer, you may seek advice from legal counsel of your choice.
Transfer Requirements

1. Completed Transfer of Ownership with W-9 Form (enclosed) or a letter of

instruction.
2. The original stock certificate(s), unless holdings are in book entry and no physical
certificate(s) is/are held.
>If you are unable to locate your original stock certificate(s) due to theft or loss,
please log into your account at www.astfinancial.com to report the loss.
Required
3. FOR TRANSFER OF $10,000 OR LESS: The Medallion Signature Guarantee
Documentation requirement may be waived. To request such waiver, please submit your transfer
paperwork, processing fee of $50 in the form a check payable to American Stock
for All Transfers Transfer & Trust Company, LLC, AND copy of a valid government issued photo
of Ownership identification with a signature, such as a driver’s license or a passport.

FOR TRANSFERS OVER $10,000: A Medallion Signature Guarantee is

required. Obtain a Medallion Signature Guarantee from an eligible financial
institution that guarantees your legal capacity to sign the Transfer of Ownership,
along with your W-9 Form or letter of instruction.

For more information on Medallion Signature Guarantee and Medallion Signature

Guarantee Waiver, please see the FAQs.

Type of Transfer Additional Required Documents

INDIVIDUAL
Transfer to another • No additional documents; only submit the documents mentioned above
individual
Transfer due to name change • Name change requests due to marriage or divorce must be accompanied by a
certified true copy of the marriage certificate or a divorce decree

One owner and the owner is
deceased
• Certificate of Appointment (or Small Estate Statutes of the state in which the
shareholder was domiciled)
> Refer to the state in which the registered owner was domiciled because you may
need a certified copy with a raised seal that must be dated within 60 days of the
requested date of transfer (in New York, six months)
> In lieu of a Certificate of Appointment, and if the value of the shares being
transferred falls within the Small Estate Statutes of the state in which the registered
owner was domiciled, you may follow those guidelines
> Foreign Domicile Items (including Canada) require a Federal Transfer Certificate
• Completed and notarized Affidavit of Domicile
• Photocopy of official death certificate
• An Inheritance Tax Waiver is required by certain states. See question 17 in the FAQs
section to determine if an Inheritance Tax Waiver is required

TENANCY ACCOUNTS
Two owners and one or more • Completed and notarized Affidavit of Domicile
owner(s) is/are deceased • Photocopy of official death certificate(s)
with rights of survivorship
• An Inheritance Tax Waiver is required by certain states. See question 17 in the FAQs
(Joint Tenants)
section to determine if an Inheritance Tax Waiver is required
• A Medallion Signature Guarantee (or a waiver, if applicable) is required only if adding
additional owners and/or beneficiaries; see FAQs for details on Medallion Signature
Guarantee and Medallion Signature Waiver
Transfer Requirements
Type of Transfer Additional Required Documents
Two or more owners and one or • Certificate of Appointment (or Small Estate Statutes of the state in which the
more owner(s) is/are deceased shareholder was domiciled)
(Tenants in Common) > Refer to the state in which the registered owner was domiciled because you
may need a certified copy with a raised seal that must be dated within 60 days
of the requested date of transfer (in New York, six months)
> In lieu of a Certificate of Appointment, and if the value of the shares being
transfered falls within the Small Estate Statues of the state in which the
registered owner was domiciled, you may follow those guidelines
> Foreign domicile items (including Canada) require a Federal Transfer Certificate
• Completed and notarized Affidavit of Domicile
• Photocopy of official death certificate(s)
• An Inheritance Tax Waiver is required by certain states. See question 17 in the
FAQs section to determine if an Inheritance Tax Waiver is required

TRANSFER ON DEATH (TOD)

Owner or beneficiary deceased
• Owner deceased
> Completed and notarized Affidavit of Domicile
> Photocopy of official death certificate
> An Inheritance Tax Waiver is required by certain states. See question 17 in the
FAQs section to determine if an Inheritance Tax Waiver is required
• Beneficiary deceased
>Only one beneficiary can be designated per registration

CUSTODIAN ACCOUNT
Transfer from former minor
• Minor reaching age of majority
> Photocopy of official birth certificate, state issued driver’s license, or government
issued ID
> A Medallion Signature Guarantee (or a waiver, if applicable) can be utilized in
lieu of the above identification; see FAQs for details on Medallion Signature
Guarantee and Medallion Signature Guarantee Waiver

Change of Custodian • Court order appointing a successor custodian or guardian

TRUST
Transfer to trust • Copies of the relevant pages of the trust agreement, which includes the trust title,
trust date and trustees

Transfer from trust • In the event one or more trustees is/are deceased, certified death certificate(s)
is/are required
• If a successor trustee is not appointed, a certified court order naming the
successor trustee is required
Transfer Requirements
Type of Transfer
OTHER
Transfer from corporation
partnership, charity,
proprietorship, etc.
Transfer from foreign owner
who is deceased
Transfer from Individual
Retirement Account (IRA)
Transfer to a broker
Transfers involving shares valued greater than $10 million will require the highest valued Medallion Signature Guarantee
(‘Z’ prefix). Upon a full examination of all submitted documentation, we may reach out to you for additional information.
Additional Required Documents
• Certified copy of corporate resolution, partnership agreement, or attestation affidavit
of sole proprietorship
• Signature of authorized person(s) in their legal capacity
• A Medallion Signature Guarantee (a limited Power of Attorney can be created in the
United States to affect your transfer) or a Medallion Signature Guarantee Waiver if
applicable; see FAQs for details on Medallion Signature Guarantee and Medallion
Signature Guarantee Waiver
• A Transfer Certificate (Federal Tax Waiver)
> A transfer certificate is required unless: 1) An United States Executor or Administer
is appointed, or 2) AST receives a written statement from the foreign executor
or administrator attesting: (a) the decedent was not a citizen of the U.S., (b) the
decedent died on or after January 1, 1977, and (c) the U.S. value of the estate at the
time of death was $60,000 or less
> Photocopy of official death certificate
• A Medallion Signature Guarantee (or a waiver, if applicable) must be obtained by the
current registered custodian of the IRA
• If you wish to transfer your shares to your broker, please contact them directly for
further instructions
Frequently Asked Questions (FAQs)
1. What is a Medallion Signature Guarantee?
A Medallion Signature Guarantee is a special
signature guarantee for the transfer of securities. It is
a representation by the guarantor that the signature is
genuine and the signer is an appropriate person with the
legal capacity to sign.
2. How can I obtain a Medallion Signature Guarantee
Waiver?
We offer a Medallion Signature Guarantee Waiver. For
transfers of shares with aggregate value of $10,000 or
less on the date on which the transfer request is
signed, you can obtain a waiver from the requirement for
a Medallion Signature Guarantee by submitting your
transfer paperwork, processing fee of $50 in the form of a
check payable to American Stock Transfer & Trust
Company, LLC, AND copy of a valid government issued
photo identification with a signature, such as a driver’s
license or a passport.
3. Where can I obtain a Medallion Signature
Guarantee?
An eligible financial institution such as a commercial bank,
trust company, securities broker/dealer, credit union, or
savings institution participating in the Medallion Signature
Guarantee program must guarantee the signature(s).
4. Is there a fee to transfer shares?
AST does not charge a transfer fee. However, there may
be fees for replacing a lost certificate and/or obtaining a
Medallion Signature Guarantee from the financial
institution of your choice. The Medallion Signature
Guarantee Waiver, if applicable, is available for a fee of
$50.
5. What is a Form W-9 and why is it required?
A Form W-9 certifies the Taxpayer Identification Number
(TIN, also known as a Social Security Number or
Employer Identification Number) listed on an account. A
Form W-9 is required each time a new registration or new
account is established. The IRS requires that AST
withhold a portion of the earnings on accounts that have
not been certified by submitting a completed Form W-9.
6. What if I am not a U.S. citizen or do not have a Social
Security Number?
If you are not a U.S. citizen or do not have a Social
Security Number, please use the appropriate Form W-8. In
this case, leave the Substitute Form W-9 section on the
Transfer of Ownership form blank. If an account is not
certified, the new owner, who is a non-U.S. taxpayer, will
be subject to U.S. withholding from all earnings or sale
proceeds as regulated by the IRS.
7. What are the options for my Transfer Reason?
On the Transfer of Ownership with W-9 Form, you will
have four options for your Transfer Reason and can only
select one. You may want to consult with your tax advisor
on the definition and tax implications for each type of
transfer.
• Gift: Include the date the gift was received or the
gift date will default to the date that the transfer is
processed.
• Death: Include the date of death or it will default to the
date indicated in the documents received (e.g., death
certificate). The cost basis per share will default to
the fair market value on the date of death unless an
alternate value is provided by the designated estate
representative.
• Private Sale: Include the date of sale and the cost
basis per share.
• No Change of Ownership: Change of name in cases
of marriage or divorce, minor coming of age, addition
of spouse to registration, etc. (Existing cost basis of
shares will be carried over to the new account.)
8. How do I transfer shares to multiple owners?
You must submit a fully completed Transfer of Ownership
with W-9 Form for each new owner with original signatures
Medallion Signature Guaranteed. Please see question #2
in this FAQ to determine if you are eligible for a waiver
from this requirement.
If shares are being transferred to multiple new owners
individually, AST cannot accept instructions using words
such as “equally” or “divided between” for multiple parties.
The actual number of shares being transferred must
be listed on the Transfer of Ownership with W-9 Form.
If multiple owners are to be listed under one account,
please identify the preferred form of ownership (e.g., Joint
Tenants, Tenants in Common, etc.).
9. Are dividend options available to the new owner?
Dividend policies depend on the particular stock held.
Listed below are AST’s guidelines for dividend payments,
provided that the company pays dividends.
• When a company has a Dividend Reinvestment Plan
(DRIP) that allows for reinvestment of dividends, the
following applies: The new owner may choose the
reinvestment option as provided on the Transfer of
Ownership with W-9 Form. The new owner may also
enroll in the plan by accessing their account from our
website at www.astfinancial.com.
• When a company does not have a DRIP, the following
applies: The new account will be setup to receive
dividend checks.
• Can cash dividends be setup for direct
deposit for the new account? If the company offers
direct deposit of dividends, the new owner
can arrange for direct deposit by downloading
a direct deposit form from our website
at https://astfinancial.com/knowledge-center/forms.
Please be advised some companies do not offer direct
deposit of dividends.
10. What if I cannot locate my certificate(s)?
To provide you with replacement certificates, we
must be notified of the loss in writing. You may also report
the loss online by accessing your account at
www.astfinancial.com. A bond of indemnity to replace lost
shares must be obtained at your expense.
11. What if I locate my certificate(s) previously reported
lost or stolen?
If you previously reported your certificate(s) lost or stolen,
and you are now in possession of the certificate(s), you
must send a signed letter authorizing AST to release the
STOP in order to execute your transfer request.
Frequently Asked Questions (FAQs)
12. What is a bond of indemnity?
A bond of indemnity protects AST and its clients from any
liabilities incurred if the original certificate(s) is/are
presented for value in the future. A bond of indemnity can
also be obtained independently from your own insurance
provider or an insurance company of your choice.
13. Does AST have an insurance provider that I (we) can
use?
As a convenience, you may elect to have AST include
your lost certificate(s) under our insurance provider,
Travelers Casualty and Surety Company of America.
However, there will be fees associated with using our
provider.
If you chose to be included under our insurance coverage,
AST will send you an Affidavit of Loss and Indemnity
Agreement to be completed with signatures notarized.
You will be required to pay a percentage of the market
value of the lost securities at the time the loss affidavit is
issued and an administrative fee. This payment is required
for the bond coverage needed to process replacement of
the lost certificate(s).
Completed, notarized affidavits and a check for the
processing fee may be submitted with appropriate transfer
documentation, and replacement securities will be issued
in the name of the new shareholder.
14. What is a Certificate of Appointment?
A Certificate of Appointment is a court-issued document
that proves the authority of the estate trustee to administer
the provisions of the deceased’s will. Contact the state in
which the registered owner was domiciled to determine
whether or not you need a Certificate of Appointment.
15. What is a certified true copy of a document?
A certified true copy is a copy of a document which has
been stamped and signed as a true copy of another
original document. It is made by an individual who is
allowed to take declarations.
16. What is the Affidavit of Domicile form, and when
should I complete one?
An Affidavit of Domicile is a sworn statement which is to
be signed before an official notary public. The purpose of
this form is to enable AST to secure the transfer of shares
owned by the deceased at the time of his or her death
under the laws of the deceased’s legal residence.
You are required to complete and submit an Affidavit of
Domicile to AST when transferring shares involving a
deceased shareholder.
17. What is an Inheritance Tax Waiver, and how can I
determine if one is needed?
An Inheritance Tax Waiver is an authorization by the tax
department of a deceased’s estate to transfer the
securities of the deceased without charging any taxes.
Most states do not require an Inheritance Tax Waiver.
However, if the deceased resided in Puerto Rico or any
states listed, you must submit the Inheritance Tax Waiver
to AST when transferring those shares.
• Alabama • New Jersey • Rhode Island
• Hawaii • New York • Tennessee
• Illinois • North Dakota • West Virginia
• Indiana • Ohio
• Missouri • Oklahoma
• Montana • Pennsylvania
To determine the specific Inheritance Tax Waiver
requirements for the states listed above, please contact
the appropriate tax authority such as the Department of
Revenue, Tax Commission, Department of Treasury, etc.
18. What if I don’t wish to transfer my shares but need
to change the name on the account?
To change or correct a name or to alter an account title in
any form is considered a transfer and a Medallion
Signature Guarantee is required.
If shares are in certificate form, the original certificate(s)
must be submitted in order to execute the name change
request.
19. What are the Uniform Gifts to Minors Act and the
Uniform Transfers to Minors Act?
The Uniform Gifts to Minors Act (UGMA) is an act in some
states of the U.S. that allows assets such as securities,
where the donor has given up all possession and control,
to be held in the custodian’s name for the benefit of the
minor without an attorney needing to set up a special trust
fund.
Once the child reaches the age of majority (18 or 21,
depending on the state), the assets become the property
of the child and the child can use them for any purpose.
In the majority of states that have adopted the Uniform
Transfers to Minors Act (UTMA), the assets are treated
similarly. The assets are held in the custodian’s name
until the child reaches age of majority.
20. How can I access my account online?
Follow the steps below to access information about your
account:
• Go to www.astfinancial.com and click on Client
Login in the top right corner.
• Next click on Manage My Accounts, then select U.S.
Shareholders & Investors, then select Manage My
Shareholder Account.
• If you are already registered, click Login on the left
hand side of the screen and enter your unique ID and
password. If you are not registered, you will need to
click Register on the left side of the screen to create a
unique ID and password.
• Once registered and your unique ID and password are
entered, your “Account Information” page will appear.
Checklist

Required for ALL Transfers - Be Sure to Send:

Original stock certificate(s) or Affidavit of Loss (if applicable)

Your completed Transfer of Ownership form with W-9/W-8 OR a letter of instruction with W-9/W-8

A Medallion Signature Guarantee covering the value of the shares OR if applicable, a Medallion Signature
Guarantee Waiver, including a payment of $50 and government issued photo ID with a signature

An Inheritance Tax Waiver (if required by the state)

A STOP Release Request if your certificate(s) was/were previously reported lost, stolen, or damaged and
now is/are currently in your possession

If Transfer Involves a Deceased Individual, Send:

The Affidavit of Domicile

A photocopy of the original death certificate(s)

A Certificate of Appointment

If Transfer to a Trust, Send:

Copies of the relevant pages of the trust agreement, which includes the trust title, trust date and trustees

If Transfer Involves a Corporation, Send:

A corporate resolution, partnership agreement, or attestation affidavit

If Transfer Involves Name Change or Attaining Age of Majority, Send:

A photocopy of the original birth certificate

A certified copy of the marriage certificate

A certified copy of the divorce decree

If You Wish to Reinvest Your Shares (available only for those companies that offer this
feature), Send:
A letter of instruction or select the appropriate box on the Transfer of Ownership form

Should you need any additional information regarding your Transfer of Ownership, please contact AST Shareholder
Services at (800) 937-5449.

© 2018 American Stock Transfer & Trust Company, LLC. All rights reserved.
 Transfer of Ownership with W-9 Form
Page 1 of 3: Current Registration
Instructions are located within each section of the form.
Please print clearly.

1 Name of Stock to Be
Transferred:
Enter the full name of the stock
to be transferred.

2 AST Account Enter the AST 10-digit numerical account number

printed on all account mailings.
Number:

3 Current Registration:
Enter the current registration
as it appears on the account(s)
to be transferred.

4 Transfer Reason: Check only one box below. All transfers will be assumed to be gifts if no reason is provided. If we receive documentation
(e.g., death certificate) indicating that the registered shareowner is deceased, the transfer reason will default to death. For more information about
your Transfer Reason, see question 7 in the FAQs section of the Transfer of Ownership Package.

Gift: Date of Gift: ____________ Death: Date of Death: ____________ Cost Basis Per Share: _______. ___

Private Sale: Date of Sale: ___________ USD Cost Basis Per Share: _______._____USD
No Change of Ownership (please specify):

5 Date: Daytime
Phone #:
Email
Address:

6 Signature of Assigner(s)
and Capacity (if applicable): SIGNATURE CAPACITY

SIGNATURE CAPACITY

I do hereby irrevocably constitute and appoint American Stock Transfer & Trust Company, LLC (AST), attorney to
transfer said stock on the books of the corporation with full power of substitution in the premises.
If the current owner is not signing this Transfer of Ownership form, the legal representative signing on their behalf must state next to their signature
the capacity in which they are authorized to sign. Such capacity as executor or administrator for a deceased owner; power of attorney; heir, and the
like, is to be defined and proven to the Guarantor in order to obtain a Medallion Signature Guarantee.

7
Medallion Signature Guarantee PLACE MEDALLION SIGNATURE GUARANTEE HERE

All signatures must be Medallion Signature Guaranteed by an eligible Guarantor

Institution OR a Medallion Signature Guarantee Waiver may be obtained for transfers
of $10,000 or less; please see FAQ, question #2 for details. No other form of signature
verification, including a notary seal, can be accepted.

Not familiar with a Medallion Signature Guarantee?

For more information, please see questions #1 and #2 in the FAQs section of the
Transfer of Ownership Package.
 Transfer of Ownership with W-9 Form
Page 2 of 3: New Registration
Instructions are located within each section of the form.
Please print clearly.

8 New Registration:
Enter full name of the new
registration.

9
# of Certificated Shares
(Certificate(s) or Affidavit
# of Book Shares # of DRIP Shares Total # of Shares
of Loss must be
submitted) + + =

FOR DRP SHARES ONLY:

When a transfer involves Dividend Reinvestment Plan (DRIP) shares, if the new owner intends to have Reinvest Dividends (if applicable)
the shares remain enrolled in the company’s reinvestment program, they must check the box next to
“Yes” in order to reinvest their dividends. For more information about DRIP shares, see question 9 in Yes No
the FAQs section of the Transfer of Ownership Package. If checking yes, I have read and fully understand
the terms and conditions of the Plan.

10 Registration:
Type of Individual Transfer on Death (TOD) Name of Beneficiary:__________________________
Select the Joint Account Trust Trustee:___________________________ Trust Date: ____________
registration type.
Custodian Account Other:_____________________________________________________________

Check the box above that corresponds with the type of registration.
• Joint Account: “joint tenants” unless otherwise indicated.
• Trust: include name of trustees, trust title and date.
• Custodian Account: Uniform Transfers to Minors Act (UTMA) or Uniform Gifts to Minors Act (UGMA) is based on the state (ST) in which the
custodianship was created. For more information on UTMA/UGMA, see question 18 in the FAQs section of the Transfer of Ownership
Package.
• Transfer on Death (“TOD”): only one beneficiary may be named on a TOD account.

Examples of Type of Registration

Joint Account: Joint Tenants John Smith and Mary Smith JT Ten

Joint Account: Tenants in Common John Smith and Mary Smith Ten Com

John Smith TTEE

Trust John Smith Trust
U/A DTD 01/23/2014

John Smith Cust

Custodian Account
Mary Smith UTMA/ST

Transfer on Death (“TOD”) John Smith TOD Jane Smith Subject to STA TOD Rules
 Transfer of Ownership with W-9 Form
Page 3 of 3: New Registration
Instructions are located within each section of the form.
Please print clearly.

11 Full Address:
Enter the complete address of
the new owner.

12
/
Substitute Form W-9
Check the appropriate box:
Individual/Sole Proprietor
S Corporation
Limited Liability Company:
Enter the tax classification (C = C Corporation,
S = S Corporation, P = Partnership)
Other: _____________________
Part I: Taxpayer Identification Number
(TIN)
C Corporation
Enter your TIN in the box. The TIN provided
Partnership must match your name to avoid backup
withholding. For individuals, this is your
Social Security Number (SSN).
Trust/Estate
Exempt Payee
Exempt payee code or Exemption from
FATCA reporting code (if any) _______
codes apply only to certain entities not
individuals

Part II: Certification

Under penalties of perjury, I certify that: (1) The number shown on this form is my correct taxpayer identification
number (or I am waiting for a number to be issued to me); and (2) I am not subject to backup withholding because:
(a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that
I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has
notified me that I am no longer subject to backup withholding; and (3) I am a U.S. citizen or other U.S. person; and
(4) The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct.
Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are
currently subject to backup withholding because you have failed to report all interest and dividends on your tax
return. For real estate transactions, item 2 does not apply. For mortgage interest paid, acquisition or abandonment
of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and
generally, payments other than interest and dividends, you are not required to sign the certification, but you must
provide your correct TIN.

SIGNATURE Date:
The new owner must sign the Substitute Form W-9. Failure to complete this form will result in backup withholdings
per IRS regulations. If the new account is to be registered to Joint Tenants, use the Taxpayer Identification
Number (TIN) of the first owner named on the account. If you are not a U.S. citizen or do not have a Social
Security Number, please use the appropriate Form W-8.
 Affidavit of Domicile
Page 1 of 2: Form
Instructions are located on page 2.
Please print clearly.

1 Name of Stock to Be
Transferred:

2 AST Account Number:

This form must be completed by the executor, administrator, personal representative, or survivor.

3 Full Name of Person

Completing this Form:

I am the (check one): Executor Administrator Personal Representative Survivor

4 Legal Address of
Person Listed Above:

5 Full Name of
Decedent:

6
Date of Death of
Decedent:
MM/DD/YYYY

7 Legal Residence
of Decedent:

City State County

of : of: of:

8 checked above) of the Estate of the registered owner, whose name, date of death and legal residence are listed above.
I, being duly sworn, depose and say that I am the executor, administrator, personal representative, or survivor (as

Signature of person
completing this form:

This affidavit confirms that American Stock Transfer & Trust Company, LLC ("AST") is the transfer agent that has
permission to transfer or deliver securities registered in the name of, or owned by, said decedent at the time of his/her death.

Official Notary Public Certification and Seal

9
Sworn before me on this date: AFFIX NOTARY PUBLIC SEAL BELOW

Day of , 20
Signature of
Notary Public:
State of____________________) ss.

County of__________________)
Expiration of
Commission:
 Affidavit of Domicile
Page 2 of 2: Instructions
Please read carefully.

Please enter all of the information in the presence of a notary.

1 Full name of the stock to be transferred

2 AST 10-digit numerical account number printed on all account mailings
3 the capacity
Full name of the executor, administrator, personal representative, or survivor and check the box next to

4 Legal address of the executor, administrator, personal representative, or survivor

5 Full name of the registered owner
6 Date of death for the registered owner
7 Legal residence of the registered owner
8 Executor, administrator, personal representative, or survivor must sign his/her name
9 Official notary public to complete certification and affix seal
IMPORTANT! Steps 1-8 are to be completed by the executor, administrator, personal
representative, or survivor in the presence of a notary. Step 9 should be completed by an
official notary public.