BROKERAGE ACCOUNT TRANSFER FORM

Account Type for the Account you are transferring from and the new account you have established must be the same for both accounts. (Check One)

Traditional IRA	Rollover IRA
Roth IRA	Education IRA

Please remember, you may only transfer those securities that are on the BUYandHOLD Companies List available at www.buyandhold.com/research/.

Section 2 - Customer Information:

Account Name:	______________________________________________________
BUYandHOLD Account Number:	______________________________________________________
Social Security or Tax ID Number:	______________________________________________________
Daytime Phone Number:	______________________________________________________

Section 3 - Please deliver the securities from:

Account Name:

______________________________________________________

Brokerage Account Number:	______________________________________________________
Brokerage Firm:	______________________________________________________ (This is the Brokerage Firm that currently holds the assets you would like to transfer.)

Section 4 - Securities and Dollar Amount to Transfer: (Attach additional pages if necessary. Check only one of the boxes listed below.)

Full Transfer

Please transfer all assets in kind, except for Money Market funds which should be liquidated and transferred as cash.

Partial Transfer (Please attach additional sheets to list stocks, if necessary.)

Only transfer securities listed below.

Name of Security: (Delivering firms will not be able to transfer fractional shares. Your signature below will authorize the liquidation of any fractional shares.)

Number of Shares

_______________________________________________________

__________

Dollar Amount:

$_____________________________

Money Market funds must be liquidated and transferred as cash. Your signature below will authorize this liquidation.

Section 5 - Please sign the appropriate areas below:

Please transfer all assets in the above-referenced account to BUYandHOLD, a Division of Freedom Investments, Inc. I understand that to the extent that any assets are not readily transferable, with or without penalties, such assets may not be transferred within the timeframes required by NYSE Rule 412 or similar rule of the NASD or other designated examining authority. Since fractional shares are non-transferable, the delivering party upon the transfer of the whole shares shall liquidate any and all fractional shares and transfer the resulting dollar amount to my BUYandHOLD account. The delivering party may, in its discretion, charge a fee for this liquidation. I authorize the delivering party to deduct any fees from the credit balance in my account. If my account does not contain a credit balance or the credit balance is insufficient to satisfy said fees I then authorize the delivering party to liquidate assets in my account to the extent necessary to satisfy any outstanding fees due to it. If the assets being transferred are part of an IRA plan, and I am over 70 ? years of age, I attest that none of the assets to be transferred will include the required mandatory distribution for the current year pursuant to Section 401(a)(g) of the Internal Revenue Code. If certificates in my account are in your physical possession, I instruct you to transfer them in good deliverable form, including affixing any necessary tax waivers, to enable the successor custodian to transfer them in its name for the purpose of sale, when and as directed by me. I understand that upon receipt of this transfer instruction, the delivering party will cancel all open orders for my account on its books. I affirm that I have destroyed or returned to the delivering firm all credit/debit cards and/or unused checks issued to me in connection with my securities account. I agree that BUYandHOLD, a Division of Freedom Investments, Inc., and its affiliates will not be liable for any consequential, incidental, special or indirect damages that may result from the initiation of this transfer and I shall hold it and its affiliates and their respective officers, directors, employees and agents harmless for and against any claims arising from the transfer of the foregoing assets.

Applicant Signature:

X_________________________

Date:

______________________

Joint Applicant Signature:

X_________________________

Date:

______________________

BUYandHOLD Use Only
Letter of Authorization for IRA Accounts:
To the prior Trustee or Custodian: Please be advised that BUYandHOLD, a Division of Freedom Investments, Inc. will accept the above captioned account as successor IRA custodian.

Successor Custodian Signature ________________________________________ Date _________________________