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CollegeAmerica
Distribution Request
Lit. No. CAIDFM-005-1221O CGD/9434-S87434 © 2021 Capital Group. All rights reserved.
6
Authorization and signature guarantee
This document may not be signed using Adobe Acrobat Reader’s “ll and sign” feature.
I direct American Funds Service Company
(
AFS
)
to make distributions from the CollegeAmerica Account in the manner I have indicated, and
I assume sole responsibility for the tax consequences of the above election. I certify that the above information and attached documentation
are accurate, and I am entitled to receive the payments for which I have applied.
If I have agreed to allow American Funds to retain bank information for future ACH requests, I authorize AFS, upon request via phone, fax,
or any other means utilizing telecommunications, including wireless or any other type of communication lines by authorized persons with
appropriate account information, to 1
)
redeem fund shares from this account and deposit the proceeds into the bank account identied on this
document; and/or 2
)
secure payments from the bank account into this account. I authorize the bank to accept any such credit or debit to my
account without responsibility for its correctness.
In consideration of AFS acting on such instructions and processing such transactions, or should I not be entitled to all or any part of the
payments for which I have applied, I agree to hold harmless and indemnify Virginia529; AFS; any of their afliates or mutual funds managed
by such afliates; and each of their respective directors; trustees; ofcers; employees; and agents from any losses, expenses, costs or liability
(
including attorney fees
)
that may be incurred as a result of AFS acting on such instructions. In addition, if direct deposit payments are
requested, I understand that this payment may be terminated by me at any time by telephone or written notication to AFS. The termination
request will be effective as soon as AFS has had reasonable time to act upon it.
X
/ /
Name of Account Owner or Custodian Signature of Account Owner or Custodian Date (mm/dd/yyyy)
A signature guarantee is required unless the redemption
request is:
• made payable to the Account Owner, an eligible educational
institution, or the Beneciary; and
• less than $125,000 or less than $25,000 if made payable to the
Beneciary; and
• sent to an eligible educational institution or the address of record
(
as
long as the address has not changed in the last 10 calendar days
)
OR
• reinvested into an existing or new American Funds account.
Note regarding ACH redemptions: A signature guarantee is required unless installment payments are being requested, the CollegeAmerica
Account Owner is included in the bank account registration, and the request is received at least 10 calendar days prior to the rst draft.
If required, signatures must be guaranteed by a bank, savings association, credit union, member rm of a domestic stock exchange or
the Financial Industry Regulatory Authority that is an eligible guarantor institution. A notary public is NOT an acceptable guarantor.
The guarantee must be in the form of a stamp or a typewritten or handwritten guarantee that is accompanied by a raised corporate seal.
Note:
A medallion guarantee is acceptable in place of a signature guarantee.
If a signature guarantee is required, mail this completed form to the service center
for your state using the maps below. Otherwise, you may fax it to (888) 421-4351.
GUARANTOR:
Stamp signature guarantee or medallion guarantee here.
If mailing, choose the service center for your state. Mail the form to the Indiana Service Center if you live outside the U.S.
American Funds Service Company
P.O. Box 6273
Indianapolis, IN 46206-6273
Overnight mail address
12711 N. Meridian St.
Carmel, IN 46032-9181
American Funds Service Company
P.O. Box 2713
Norfolk, VA 23501-2713
Overnight mail address
5300 Robin Hood Rd.
Norfolk, VA 23513-2430
For more information, contact your nancial professional, visit www.capitalgroup.com or call us at (800) 421-4225.
Investor upload www.capitalgroup.com/submit Financial professional upload www.capitalgroup.com/upload Fax (888) 421-4351
