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									EdVest Account Application
                  SM


For Trusts, Partnerships, Corporations, and Other Entities

Complete this application to establish an EdVest account with a trust, partnership, corporation, or other
entity as the account owner. If you would like to open an EdVest account with an individual as the account
owner or a custodian for a UGMA/UTMA account or would like help completing this application, call us                           App #:                      738862827
toll-free at 1-888-338-3789. Representatives are available 24 hours a day, 7 days a week. Information is also
                                                                                                                               Acct #:
available online at www.EdVest.com.

1      r E g i s T r AT i O n A n d m A i l i n g A d d r E s s ( P l E A s E P r i n T )

                                    imPOrTAnT inFOrmATiOn: Prior to opening an account, we require that you provide us with the entity’s name, street address, and
                                    taxpayer identification number. If you are establishing an account as attorney-in-fact on behalf of the account owner, contact Wells Fargo
                                    for instructions to properly establish the account.

                                      Choose one:
                                        Trust: We require a copy of the title and signature pages of the trust document with the application.
                                        Partnership: We require a copy of the partnership agreement with the application.
                                        Corporation: We require a certified copy of your Articles of Incorporation with the application.
                                        501(c)(3): We require a copy of the ruling or determination letter from the IRS with the application.
                                        Other entity (list type): ____________________________ We require a copy of documentation supporting the entity’s
                                        establishment with the application.


                                     Treyvon                                                                          435-93-1420                                02/15/1996
                                    Name of trust, partnership, corporation, 501(c)(3), or other entity              U.S. taxpayer identification number        Date of trust (mm/dd/yyyy)
                                                                                                                                                                (if applicable)
                                     222 Barksdale Dr                                                                 Broussard                                  LA             70518
                                    U.S. street address—principal place of business or local office                  City                                       State           Zip code


                                    U.S. mailing address (if different than U.S. street address)                     City                                       State           Zip code
                                     nkkcrmr@gmail.com                                                                (337) 330-2862                             (337) 000-0000
                                    E-mail address                                                                   Daytime phone                              Evening phone

                                    Country of incorporation/Organization:                      United States (Entity must be incorporated/organized in the United States to be eligible
                                    to participate in the program.)


2      T r u s T E E / PA r T n E r / O F F i C E r i n F O r m AT i O n

                                    imPOrTAnT inFOrmATiOn: Prior to opening an account, we require that you provide us with your name, street address, date of birth,
                                    and Social Security number. If you are establishing an account as attorney-in-fact on behalf of the account owner, contact Wells Fargo for
                                    instructions to properly establish the account.

                                    Christopher Broussard                                                              434-21-3113                               08/01/1969
                                    Name of trustee, partner, or officer (first, middle initial, last)               Social Security number                     Date of birth (mm/dd/yyyy)
    To list additional              222 Barksdale Dr                                                                   Broussard                                 LA              70518
    trustees, partners,
                                    U.S. residential street address of trustee, partner, or officer                  City                                       State           Zip code
    or officers, include            Nicole Broussard                                                                                                             02/08/1972
                                                                                                                       436-19-4836
    all information in
                                    Name of trustee, partner, or officer (first, middle initial, last)               Social Security number                     Date of birth (mm/dd/yyyy)
    this section on a
                                    222 Barksdale Dr                                                                   Broussard                                 LA              70518
    separate sheet.
                                    U.S. residential street address of trustee, partner, or officer                  City                                       State           Zip code



3      d E s i g n AT E d b E n E F i C i A r y i n F O r m AT i O n


                                     Treyvon Sam                                                                      435-93-1420
                                                                                                                                                                  Male or       Female
                                    Name of designated beneficiary (first, middle initial, last)                     Social Security number
    All information in this                                                                                           Broussard                                  LA             70518
                                     222 Barksdale Dr
    section is required to
                                    Street address                                                                   City                                       State           Zip code
    establish an account.
                                    Entity                                                                            02/15/1996
                                    Relationship to account owner                                                    Date of birth (mm/dd/yyyy)

                                    Citizenship:        U.S. citizen       Resident alien (Nonresident aliens are not eligible to participate in the program.)


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4   A n T i C i PAT E d y E A r O F E n r O l l m E n T

                                                                                                                                   14
                                 Provide the anticipated year the designated beneficiary will begin college: 20                           .
                                 Note: If no year is entered, we will add 18 years to the designated beneficiary’s date of birth if the birth month is January through August and 19 years if the
                                 birth month is September through December.

                                 TrusT, PrOCEEd TO sECTiOn 6. All OThEr EnTiTiEs, PrOCEEd TO sECTiOn 5.


5   PA r T n E r s h i P, C O r P O r AT i O n , O r 5 0 1 ( C ) ( 3 ) A u T h O r i Z AT i O n A n d C E r T i F i C AT i O n

                                 The following individual(s) is (are) duly authorized by resolution or otherwise to purchase, sell, assign, transfer, exchange, and/or deliver
                                 securities on behalf of the entity listed in section 1 (“Entity”) in connection with ownership of interests in the applicable Portfolio of the
                                 college savings plan (including, without limitation, executing forms for any account options offered by the college savings plan and
                                 modifying such account options). If only one person is authorized to act on behalf of the Entity and the individual is the sole officer of
                                 the Entity, the undersigned certifies that: (1) he/she is the sole officer of the Entity and that all information contained within this section is
                                 accurate; and (2) the Entity’s Articles of Incorporation or Charter and Bylaws provide that he/she is the only person authorized to so act.
                                 This authorization is a continuing one, and such authorization shall remain in full force and effect until the Program Manager receives
                                 and has had a reasonable amount of time to act upon a written notice of revocation or the authorization is amended by another
                                 properly completed form.
                                 number of signatures required for written transactions:                              (If no number is indicated, only one signature will be required.)


                               7
                                 Signature                                                                    Print name                                                             Date


                               7
                                 Signature                                                                    Print name                                                             Date


                               7
                                 Signature                                                                    Print name                                                             Date




6   inVEsTmEnT OPTiOns

                                 Select your investment option(s) below and write the amount of your initial investment next to each Portfolio in which you choose
                                 to invest. If you choose more than one Portfolio, you will have a separate fund and account number combination for each Portfolio
                                 you select. Each fund and account number combination may be subject to a $20 nonresident annual maintenance fee. The account
                                 minimum is $250 per Portfolio unless opened with an Automatic Investment Plan (AIP) or payroll direct deposit. See the Program
                                 Description and Participation Agreement for details.
                                 Fixed Allocation Options

                                   Vanguard Stock Index Portfolio               $                                           Wells Fargo Conservative Portfolio             $
                                    Legg Mason Aggressive Portfolio             $                                           Wells Fargo Bond Portfolio                     $
                                   Wells Fargo Aggressive Portfolio             $                                           Baird Bond Portfolio                           $
                                   Wells Fargo Moderate Portfolio               $                                           Wells Fargo Money Market Portfolio $
                                   Vanguard Balanced Portfolio                  $                                           Bank CD Portfolio                              $
                                   Wells Fargo Balanced Portfolio               $                                           Credit Union CD Portfolio                      $

                                 Enrollment-based Options
                                 Investment mix changes over time, based on the estimated years to enrollment of the designated beneficiary.

                                    Aggressive Growth Track                     $
                                    Moderate Growth Track                       $
                                    Conservative Growth Track                   $




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7      iniTiAl COnTribuTiOn mEThOds

                                  Investments to your account may be made in the form of a check, a transfer from an existing Wells Fargo Advantage Funds® account, an AIP,
                                  payroll direct deposit, or a rollover contribution. A minimum initial contribution of $250 per Portfolio is needed to open your account. This
                                  minimum is waived if you establish an AIP or payroll direct deposit for your account.

                                      Check $                         (Make check payable to EdVest. We do not accept cash, starter checks, checks drawn on banks outside the United
                                      States, or credit card checks, and we may refuse checks if EdVest is not the original payee.)

                                      rollover from an Education savings Account/Qualified u.s. savings bond—All proceeds held by the current custodian must
                                      be liquidated before establishing the account. The entire contribution will be treated as earnings unless we receive appropriate
                                      documentation as described in the Program Description and Participation Agreement.
                                      rollover from another 529 Account—Enclose an EdVest rollover form. A rollover form can be obtained by visiting the Web site or
                                      calling the phone number listed at the top of this application.
                                      Automatic investment Plan (AiP)—Complete the AIP information in section 8 of this application and include a voided check or a
                                      preprinted deposit slip for a savings account.
                                      Payroll direct deposit—Complete the payroll direct deposit information in section 8 of this application.
                                       Electronic Funds Transfer (EFT) $r
8      ACCOunT OPTiOns


                                 To establish subsequent contribution options by AiP or EFT, your bank account registration musT have one name in common
                                 with the EdVest account owner.
                                      Automatic investment Plan (AiP)—Automatic purchases can be made from your bank account into your EdVest account.
                                      There is a $15 minimum per investment, per account.
    include a voided
    check if you are                                                                       $                                                                                     $
    establishing an AiP               Portfolio name                                         Amount                    Portfolio name                                             Amount
    or Express Purchase
    by Electronic Funds
                                      Investment frequency for all portfolios selected:             Once a month on the                       day of the month or
    Transfer (EFT).
    Note: Checks must be                                                                            Twice a month on the                      and                 days of the month.
    preprinted with your              This privilege will be effective upon receipt of valid bank information. If no amount is chosen, your bank account will be debited $15 on the date(s) you have
    name and address. We              chosen. If no date is chosen, your account will be debited on the 25th day of the month. If the date falls on a weekend or holiday, your AIP purchase will occur on
    cannot accept starter or          the next business day. If the next business day falls in the next month, the AIP will cycle on the previous business day.

    counter checks.                   Payroll direct deposit—You may be able to contribute to your account via payroll direct deposit. We will send information that you
                                      may forward to your employer, which includes your new account number(s). Confirm that your employer offers payroll direct deposit
                                      before selecting this option.
                                  investment Change Option—You can sell shares via the Internet or by phone from one Portfolio and use the proceeds to buy shares
                                  in an identically registered EdVest account in another Portfolio. The number of investment changes that can be requested each calendar
                                  year without a change in the designated beneficiary is limited per 529 plan regulations. Refer to the Program Description and Participation
                                  Agreement for details. This option will be added to your account unless you check the following box: I do not want the Investment
                                  Change Option.
                                  redemption Option—You can sell shares via the Internet or by phone to have money sent to the account owner’s address of record
                                  or by phone to your bank account (via EFT or wire) if a voided check is provided. This option will be added to your account unless you
                                  check the following box: I do not want the Redemption Option.
                                  Express PurchaseSM —You can purchase shares via the Internet or by phone with payment from your designated bank account by EFT
                                  if a preprinted, voided check is provided. If a voided check is included, this option will be added to your account unless you check the
                                  following box: I do not want Express Purchase.


9      b A n k i n F O r m AT i O n


                                  To establish account options by EFT at any time, your bank account registration musT match the registration provided in section
                                  1 of this application. If a voided check is not enclosed with this application but you do include an investment check, we will use the
                                  information contained on the investment check to establish a requested AIP. The applicable Portfolio, Wells Fargo Funds Management, LLC,
                                  and their affiliates, subcontractors, and the officers, directors, employees, and agents of these entities (collectively “Wells Fargo”) will not
                                  be responsible for banking system delays beyond their control.
                                  I understand that by executing this application, I herein authorize my bank to honor all entries to my bank account initiated through
                                  State Street Bank and Trust Company, or any successor custodian, on behalf of the applicable college savings plan. I acknowledge and
                                  understand that Wells Fargo will not be liable for acting upon instructions believed genuine and in accordance with the procedures
                                  described in the applicable College Savings Plan Program Description and Participation Agreement or the rules of the Automated
                                  Clearing House. I further agree that any such authorization, unless previously terminated by my bank in writing, is to remain in effect
                                  until Wells Fargo receives, and has a reasonable amount of time to act upon, a subsequent notice.

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10   COnsEnT FOr EdOCumEnTs

                                 I would like to receive my account statements, transaction confirmations, program descriptions, and program description supplements
                                 electronically. If I do not consent below, I understand that I will receive my documents/statements in paper format.
                                     I consent to delivery of my college savings plan documents/statements in electronic format.
                                 I understand that I will receive an e-mail notice indicating that the most recent documents or statements are available for viewing and
                                 downloading at www.wellsfargo.com/advantagefunds and that I will need to establish a login ID and password in order to view these
                                 materials. I may change my electronic delivery preferences or unsubscribe from eDocuments at any time by logging into my account
                                 online or by calling 1-800-359-3379.


11   A C C O u n T A g r E E m E n T A n d s i g n AT u r E ( s )

                                 By signing below, I hereby apply for an EdVest account. I certify that I am opening the account to provide funds for the qualified higher
                                 education expenses of the designated beneficiary. I have received and agree to the terms set forth in the Program Description and
                                 Participation Agreement and will retain a copy of this document for my records. I understand that my account may be subject to a $20
                                 nonresident annual maintenance fee.
                                 I acknowledge that I am required to provide certain personal information, which will be used to verify my identity. My account may not
                                 be opened if I do not provide this information. I further acknowledge that Wells Fargo reserves the right to close my account or take
                                 other reasonable steps if it is unable to verify my identity.
                                 I certify that the information I have provided on this application—and all future information I will provide with respect to my EdVest
                                 account—is true, complete, and correct. I authorize Wells Fargo and EdVest to open and maintain account(s) based on this information. I
                                 represent that I am of legal age and have legal capacity to make this purchase.

 To complete this
 application, you must          7
                                 Signature of trustee, partner, or officer                  Print name (and title, if applicable)                     Date
 sign and date here.

                                7
                                 Signature of co-trustee, partner, or officer               Print name (and title, if applicable)                     Date




 before you mail, have you:         Provided all required information in sections 1 and 2?                              Selected an investment option in section 6?
                                    Enclosed the appropriate document as required in section 1?                         Signed your application in section 11?
                                    Completed designated beneficiary information in section 3?                          Included a voided check (if applicable)?
                                    Completed section 5 as required?                                                    Enclosed your check made payable to EdVest?




                                     mAil                                                                        OVErnighT
                                     EdVest                                                                      EdVest
                                     c/o Wells Fargo                                                             c/o Wells Fargo
                                     P.O. Box 55244                                                              Attn: Boston Financial
                                     Boston, MA 02205-8348                                                       30 Dan Road
                                                                                                                 Canton, MA 02021-2809




 By opening an account online, you have automatically been given the ability to perform certain transactions by phone or
 the Internet, such as purchasing more shares, changing investment options, or requesting a distribution from your
 account. If you would not like any of these options for your account, you may visit EdVest.com and fill out an Account
 Change Request form to change the account you open online, or submit an application via mail.




EdVest is a state-sponsored 529 college savings plan administered by the Wisconsin Office of the State Treasurer. Wells Fargo Funds Management, LLC, a wholly owned subsidiary
of Wells Fargo & Company, provides investment management and administrative services to the EdVest plan. Shares in the program are distributed by Wells Fargo Funds
Distributor, LLC, Member FINRA/SIPC, an affiliate of Wells Fargo & Company. 114385 01-09
Additional Online Account Application Information

1   A C C O U N T O W N E R I N F O R M AT I O N

                            nikbruce
                            Login ID




2   B A N K A C C O U N T I N F O R M AT I O N

                            Christopher Broussard
                            Bank Account Owner                                     Bank Account Joint Owner


                            Bank ABA Routing Number                                Bank Account Number




3   E-MAIL PREFERENCES


                            eDocuments Enrollment
                              Deliver statements electronically.
                              Deliver regulatory documents electronically.
                              No, I do not want any of my documents delivered electronically.

                            In what format would you like to receive e-mails?
                               HTML (graphics)
                               Text (plain text)

								
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