Get State Farm Customer Request Form 2012-2024

Letter of Direction - Mutual Funds Customer Request This document is to instruct State Farm Mutual Funds to make the following change s to the below referenced account. Please print except where signature is required* This change is being requested by your name Mutual Fund Account Owner Name Account Number or Plan ID Number Full Address as currently listed on the account City State ZIP Code Daytime Telephone number Please give detailed instructions on change s to be made to your account. Signature is required Account Owner Responsible Individual Trustee Custodian or Beneficiary Signature Date Joint Account Owner or Beneficiary Signature if applicable A signature guarantee is a written representation signed by an officer or authorized employee of the guarantor showing that the signature of the shareowner is genuine. Please take this form to a bank broker-dealer or other authorized guarantor to have your signature guaranteed* A notary cannot be accepted* Authorized Guarantor s Signature Mail completed form to For questions contact 1002779 State Farm Mutual Funds P. O. Box 219548 Kansas City MO 64121-9548 Please Print Authorized Guarantor s Name Guarantor s Stamp 800 447-4930 139497. Please print except where signature is required* This change is being requested by your name Mutual Fund Account Owner Name Account Number or Plan ID Number Full Address as currently listed on the account City State ZIP Code Daytime Telephone number Please give detailed instructions on change s to be made to your account. Signature is required Account Owner Responsible Individual Trustee Custodian or Beneficiary Signature Date Joint Account Owner or Beneficiary Signature if applicable A signature guarantee is a written representation signed by an officer or authorized employee of the guarantor showing that the signature of the shareowner is genuine. Signature is required Account Owner Responsible Individual Trustee Custodian or Beneficiary Signature Date Joint Account Owner or Beneficiary Signature if applicable A signature guarantee is a written representation signed by an officer or authorized employee of the guarantor showing that the signature of the shareowner is genuine. Please take this form to a bank broker-dealer or other authorized guarantor to have your signature guaranteed* A notary cannot be accepted* Authorized Guarantor s Signature Mail completed form to For questions contact 1002779 State Farm Mutual Funds P. Please take this form to a bank broker-dealer or other authorized guarantor to have your signature guaranteed* A notary cannot be accepted* Authorized Guarantor s Signature Mail completed form to For questions contact 1002779 State Farm Mutual Funds P. O. Box 219548 Kansas City MO 64121-9548 Please Print Authorized Guarantor s Name Guarantor s Stamp 800 447-4930 139497. Please print except where signature is required* This change is being requested by your name Mutual Fund Account Owner Name Account Number or Plan ID Number Full Address as currently listed on the account City State ZIP Code Daytime Telephone number Please give detailed instructions on change s to be made to your account. Signature is required Account Owner Responsible Individual Trustee Custodian or Beneficiary Signature Date Joint Account Owner or Beneficiary Signature if applicable A signature guarantee is a written representation signed by an officer or authorized employee of the guarantor showing that the signature of the shareowner is genuine. Please take this form to a bank broker-dealer or other authorized guarantor to have your signature guaranteed* A notary cannot be accepted* Authorized Guarantor s Signature Mail completed form to For questions contact 1002779 State Farm Mutual Funds P. .