"Deposit/Substitution Request Form" - New Jersey

Deposit/Substitution Request Form is a legal document that was released by the New Jersey Department of Banking and Insurance - a government authority operating within New Jersey.

Form Details:

  • Released on May 1, 2022;
  • The latest edition currently provided by the New Jersey Department of Banking and Insurance;
  • Ready to use and print;
  • Easy to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of the form by clicking the link below or browse more documents and templates provided by the New Jersey Department of Banking and Insurance.

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Rev. – DOBI 5.2022
DEPOSIT/SUBSTITUTION REQUEST FORM
State of New Jersey - Department of Banking and Insurance (NJDOBI)
TD Wealth
To:
To:
®
Office of Solvency Regulation
Attn: Betsy Smith
Attn: Robert L. Edge
betsy.smith@td.com
robert.edge@dobi.nj.gov
6000 Atrium Way, Mailcode: NJ5-002-132
P.O. Box 325
Mount Laurel. NJ 08054
Trenton, NJ 08625-0325
Cherry Hill, NJ 08003
Re: Commissioner of Banking and Insurance of the State of New Jersey as Trustee
Account Number:
Company Name:
Phone Number:
Fax Number:
In accordance with the administration of the Custodian Deposits held by you as Custodian for the New Jersey
Department of Banking and Insurance, we request the following transaction(s):
Free Receive Securities
Free Deliver Securities
DVP (Delivery vs. Payment)
TD Bank to buy Securities
Substitution of Securities
Securities to be deposited:
Cusip:
Description:
Par/Current Face:
Original Face:
Price:
Principal:
Interest:
Net $:
Trade Date:
Settlement Date:
Broker:
Fed Wire Instructions:
Securities to be released:
Cusip:
Description:
Par/Current Face:
Original Face:
Price:
Principal:
Interest:
Net $:
Trade Date:
Settlement Date:
Broker:
Fed Wire Instructions:
Name and Telephone Number of Company Representative
Signature of Company Representative - Date
Company faxes/e-mails form(s) to NJDOBI for approval of transaction
Required consent by the Commissioner of Banking and Insurance, State of New Jersey:
Signature of DOBI Representative - Date
NJDOBI faxes/e-mails form(s) to TD Wealth
®
approving the processing of transaction
TD Bank Representative acknowledges receipt of form:
Signature of TD Bank Representative - Date
TD Wealth
®
faxes/e-mails signed form(s) to both company and NJDOBI for completion of transaction
Comments:
Rev. – DOBI 5.2022
DEPOSIT/SUBSTITUTION REQUEST FORM
State of New Jersey - Department of Banking and Insurance (NJDOBI)
TD Wealth
To:
To:
®
Office of Solvency Regulation
Attn: Betsy Smith
Attn: Robert L. Edge
betsy.smith@td.com
robert.edge@dobi.nj.gov
6000 Atrium Way, Mailcode: NJ5-002-132
P.O. Box 325
Mount Laurel. NJ 08054
Trenton, NJ 08625-0325
Cherry Hill, NJ 08003
Re: Commissioner of Banking and Insurance of the State of New Jersey as Trustee
Account Number:
Company Name:
Phone Number:
Fax Number:
In accordance with the administration of the Custodian Deposits held by you as Custodian for the New Jersey
Department of Banking and Insurance, we request the following transaction(s):
Free Receive Securities
Free Deliver Securities
DVP (Delivery vs. Payment)
TD Bank to buy Securities
Substitution of Securities
Securities to be deposited:
Cusip:
Description:
Par/Current Face:
Original Face:
Price:
Principal:
Interest:
Net $:
Trade Date:
Settlement Date:
Broker:
Fed Wire Instructions:
Securities to be released:
Cusip:
Description:
Par/Current Face:
Original Face:
Price:
Principal:
Interest:
Net $:
Trade Date:
Settlement Date:
Broker:
Fed Wire Instructions:
Name and Telephone Number of Company Representative
Signature of Company Representative - Date
Company faxes/e-mails form(s) to NJDOBI for approval of transaction
Required consent by the Commissioner of Banking and Insurance, State of New Jersey:
Signature of DOBI Representative - Date
NJDOBI faxes/e-mails form(s) to TD Wealth
®
approving the processing of transaction
TD Bank Representative acknowledges receipt of form:
Signature of TD Bank Representative - Date
TD Wealth
®
faxes/e-mails signed form(s) to both company and NJDOBI for completion of transaction
Comments: