ES_RIA_BD_012023 — Page 1 of 2
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CollegeBound 529
Broker/Dealer Change Request Form
1. This change applies to
Acc
All of your Accountsd List of Accounts attached Individual Account
Note: Regardless of the option you select, complete Section 2.
2. Account information
Account Number
Name of Account Owner (rst, middle initial, last)
3. New Broker/Dealer information (To be completed by the nancial professional.)
Firm Name
Broker/Dealer Name (rst, middle initial, last)
Branch Number (if applicable) Advisor ID Number/IRD Number BIN Number (if applicable) Matrix Level
Mailing Address
City State Zip Code
Telephone Number
Use this form to authorize the change of the Broker/Dealer listed on your
CollegeBound 529 Account.
Type in your information and print out the completed form, or print clearly,
preferably in capital letters and black ink. Mail the form to the address listed.
Do not staple.
Forms can be downloaded from our website at www.collegebound529.com,
or you can call us to order any form or request assistance in completing this
form — at 1.877.615.4116 any business day from 8 a.m. to 8 p.m. Eastern time.
1.877.615.4116
8 a.m. to 8 p.m. Eastern Time M-F
www.coll
ege
bound529.com
Regular mailing address:
CollegeBound 529
P.O. Box 55987
Boston, MA 02205-9722
Overnight mailing address:
CollegeBound 529
95 Wells Ave, Suite 155
Newton, MA 02459
CollegeBound 529
ES_RIA_BD_012023 — Page 2 of 2
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DO NOT STAPLE
4. SIGNATURE — MUST SIGN BELOW
I certify that the information provided herein is true and complete in all respects, and that I have read, understand, consent, and agree
to all the terms and conditions of the CollegeBound 529 Program Description.
SIGNATURE
Signature of Account Owner Date (mm/dd/yyyy)
SIGNATURE
Signature of new Financial Professional Date (mm/dd/yyyy)
Invesco
State of Rhode Island
Ofce of the General Treasurer
Office of the General Treasurer
Ascensus®