UNIFORM SINGLE – OR MULTIPLE-PARTY ACCOUNT FORM PARTIES (Name one or more parties):

OWNERSHIP(Select one andinitial):

SINGLE-PARTYACCOUNT

MULTIPLE-PARTY ACCOUNT

Parties own theaccount inproportion to netcontributionsunless there is clearand convincingevidence of adifferent intent.

RIGHTS ATDEATH (Selectone and initial):

SINGLE-PARTYACCOUNT

At death of party,ownership passesas part of party’sestate.

SINGLE-PARTYACCOUNT WITHPOD (PAY ONDEATH)DESIGNATION

(Name one or morebeneficiaries):

At death of party,ownership passesto PODbeneficiaries and isnot part of party’sestate.

MULTIPLE-PARTY ACCOUNTWITH RIGHT OFSURVIVORSHIP

At death of party,ownership passes tosurviving parties.

MULTIPLE-PARTY ACCOUNTWITH RIGHT OFSURVIVORSHIPAND POD (PAYON DEATH)DESIGNATION

(Name one or morebeneficiaries):

At death of lastsurviving party,ownership passesto PODbeneficiaries and isnot part of lastsurviving party’sestate.

MULTIPLE-PARTY ACCOUNTWITHOUT RIGHTOFSURVIVORSHIP

At death of party,deceased party’sownership passesas part of deceasedparty’s estate.

AGENCY(POWER OFATTORNEY)DESIGNATION(Optional)

Agents may makeaccounttransactions forparties but do nothave ownership orrights at deathunless named asPOD beneficiaries.(To add agencydesignation toaccount, name oneor more agents):

(Select one andinitial):

AGENCYDESIGNATIONSURVIVESDISABILITY ORINCAPACITY OFPARTIES

AGENCYDESIGNATIONTERMINATESON DISABILITYOR INCAPACITYOF PARTIES.