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Membership Application/Renewal

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Membership Type:

  I am Creating a New Membership

  I am Renewing an Existing Membership

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*Company:

*Representative:

*Email:

*Phone:

*Alternate Representative:

*Alternate Representative's Email:

*Alternate Representative's Phone:

Web Site:

Fax:

TA1 or TA2#:

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Type of Membership:

Commercial Transfer Agent Member:

 Smaller (<100,000 accounts)

$500.00

 Mid-Sized (100,001 - 500,000 accounts)

$750.00

 Larger (> 500,000 accts.)  # of Accts:

$1,500.00
+$.0025 / acct.

Mutual Fund Transfer Agent Member:

 Less than 1,000,000 accounts

$1,000.00

 More than 1,000,000 accounts

$1,500.00

Fixed Asset Transfer Agent Member:

 Less than 1,000,000 accounts

$1,000.00

 More than 1,000,000 accounts

$1,500.00


 Corporate In-House Transfer Agent Member:

$1,000.00

 Non-Agent Members:

$2,000.00

Total: $0

Amount Due: $0


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