Retired

MERRILL~-

A BANK OF AMERICA COMPANY

Merrill Lynch Education Savings

Account® Distribution Form

Part 1 - Name and Address of Guardian

Your Name

Street Address

City State Zip

h Check here if this is a new address to be updated on this account’s records

Make payment from account number:

Part 2 - Reason for Withdrawal. (Check one)

h (a) Normal Distribution h (d) Withdrawal of Excess Contribution for Tax Year h (b) Distribution Due to Death of Student h (e) Rollover to another Coverdell Education Savings Account or to a h (c) Distribution Due to Divorce of Student Section 529 Qualified Tuition Program Part 3 - Withdrawal Amount. (Check one)

h 1. Part of Student’s account (please check one) Description of Securities: Use descriptions as they appear on the account statement. If you select more securities than the space provides, attach h (a) Cash* only $

a supplemental list of securities to be distributed in-kind. The securities h (b) Securities in-kind** (describe at right) you’ve selected will not be sold but will be transferred to the account h (c) Cash* $ AND securities in-kind** you have designated or mailed in certificate form, based on your election

(describe at right) within Part 5. If you do not indicate a quantity for the securities selected, the distribution may not be processed.

Quantity Security Name or Symbol

h 2. The Student’s entire account

(Your account will be closed and fees may apply.) h (a) Distribute all available cash AND sell all securities and distribute all cash proceeds as directed in Part 5. h (b) Distribute all available cash AND all eligible securities in-kind*

Part 4 - Who is the Recipient of the Withdrawal? (Check one) h The Guardian h The Student h The following Recipient for the benefit of the Student (or personal representative of the Student’s estate or to a beneficiary as designated by the Guardian in the event of death): h To the following custodian/trustee of the Education Savings Account of the Student’s former spouse, as a result of divorce: h To the following custodian/trustee: h To the following qualified educational institution: h To the following custodian/trustee of the Education Savings Account of the following family member .

(Additional documentation may be required).

JUSTIN GILLELAND

14953 FM 103

NOCONA TX 76255-6967

4

593-70023

4

4

4 1000.00

MOLLY GILLELAND

Part 5 - Where should the payment be sent? (Check one) h Transfer to Merrill account (i.e., CMA, MLESA, NextGen) number: h Mail to the address in Part 1.

h Mail to the following address:

h Pick up check at Merrill office.

Wire Call

(For office use only)

h Federal Funds Wire Transfer (Please complete the Wire Transfer instructions below. Please note that Merrill charges a transaction fee for this service. Please speak to your Merrill advisor for details.) Wire Transfer Instructions

Bank name

ABA number

Name

For credit to

Name on account

Account number

For further credit (if applicable)

Name on account

Account number

For international transfers only:

Non-Fed Member/International Bank SWIFT CODE

Merrill ESA Account Number

Part 6 - Signature

I have reviewed this form in its entirety, and hereby certify that all information as it appears is correct and may be relied upon by the custodian. Additionally, I have read the terms of the Merrill Lynch Education Savings Account Disclosure Statement and Custodial Agreement and my instructions comply with those terms.

Signature of Guardian Date

NOTES: *Cash will include available balances plus those money market fund shares or account balances invested through your accounts “daily sweep” feature.

** If you selected the distribution of securities in-kind, a fee may apply. Merrill Lynch, Pierce, Fenner & Smith Incorporated (also referred to as “MLPF&S” or “Merrill”) makes available certain investment products sponsored, managed, distributed or provided by companies that are affiliates of Bank of America Corporation (“BofA Corp.”). MLPF&S is a registered broker-dealer, Member SIPC and a wholly owned subsidiary of BofA Corp. Investment products:

Are Not FDIC Insured Are Not Bank Guaranteed May Lose Value

© 2019 Bank of America Corporation. All Rights reserved. Code 0873-1019 4

LEGEND BANK, FAO MOLLY GILLELAND

115 CLAY ST.

NOCONA, TX 76255

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