Name Change Form

NAME CHANGE REQUEST
If you have bank accounts or bank accounts and investments, return this form with any attached documents using one of these methods:
Online Mail Fax
Log in at ally.com and select Email, or log Ally Bank Subject Line: Operations
in on the Ally Mobile app and select . PO Box 951 Fax Number: 866-699-2969
Attach the form to your message. Horsham, PA 19044
If you have investments, return this form with any attached documents using one of these methods:
Online Mail Fax
Log in at ally.com and select Investments, Ally Invest Subject Line: Operations
then choose Document Upload. PO Box 30248 Fax Number: 866-699-0563
Charlotte, NC 28230
Use this form to change your legal name on your accounts.

Complete all fields for us to be able to process your name change.
Account Owner
Current Name on Accounts
FIRST NAME M.I. LAST NAME / SUFFIX
New Name on Accounts
FIRST NAME M.I. LAST NAME / SUFFIX
OCCUPATION EMPLOYER
ACCOUNT NUMBERS
Supporting Documentation
Provide a copy of one of these documents as proof of name change:
• Social Security card • Government or State Issued ID
• Marriage Certificate • Driver’s License
• Divorce Decree • Passport
• Court documents with a seal, signature, or both as needed from the issuer • Naturalization Certificate
Account Options (Ally Bank only)

Debit card and check order options below are not applicable to Online Savings and Certificate of Deposit accounts.
Spending Account:
ACCOUNT NUMBERS
Order Updated Debit Card Yes No
Order Updated Checks Yes No
Money Market Account:

ACCOUNT NUMBERS
Order Updated Debit Card Yes No
Order Updated Checks Yes No
Ally Financial Inc. Ally Bank, Member FDIC

Securities products and services are offered through Ally Invest Securities LLC, member FINRA/SIPC. Ally Bank and Ally Questions? Call 1-877-247-2559 or visit ally.com
Invest Securities are wholly owned subsidiaries of Ally Financial Inc. Securities products are NOT FDIC INSURED, NOT BANK UPDATED 06/2023
GUARANTEED, and MAY LOSE VALUE.
Questions? Call 1-855-880-2559 or visit ally.com
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NAME CHANGE REQUEST
Signature Verification and Agreement

By signing below, I am giving Ally permission to make the necessary modifications to the accounts listed.
ACCOUNT OWNER’S PRIOR SIGNATURE DATE
ACCOUNT OWNER’S NEW SIGNATURE DATE
Certification Of Taxpayer Identification Number (Form W-9 or W-8)

A Certification of Taxpayer Identification Number Form W-9 or W-8 is required for each applicant who has not already certified their Taxpayer
Identification Number at Ally. Depending on your taxpayer status, each applicant must complete, sign, and return the attached Form W-9, if you are a
U.S. person (including a resident alien), or Form W-8, if you are a foreign person. For Form W-8 see IRS website.

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CERTIFICATION OF TAXPAYER IDENTIFICATION NUMBER
FORM W-9
FORM W-9 TAXPAYER IDENTIFICATION NUMBER (TIN) CERTIFICATION (Not applicable for Non-Resident Aliens):
For individuals the TIN is your Social Security Number or Individual Tax Identification Number (ITIN) which should match the first name listed on the account
and will be used for tax reporting purposes. For other entities, it is your Employer Identification Number.
A. Social Security Number or Employer Identification Number:
B. Certification - Under penalties of perjury, I certify that:
1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me); and
2. I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal
Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has
notified me that I am no longer subject to backup withholding; and
3. I am a U.S. citizen or other U.S. person (including a U.S. resident alien); and
4. The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct.
Ally doesn’t collect Foreign Account Tax Compliance Act (FATCA) exemption codes. We’re required by law to include the aforementioned certifications,
but note that number 4 doesn’t apply.
Backup Withholding Instructions
You must check off the box to the right if you have been notified by the IRS that you are currently subject to
backup withholding because you have failed to report all interest and dividends on your tax return.
The Internal Revenue Service does not require your consent to any provision of this document other than the certifications required to avoid
backup withholding.
Customer Signature Date
SIGN
HERE
Customer Number
(Internal Use Only)
Print Name

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NAME CHANGE REQUEST

Use this form to change your legal name on your accounts.

FIRST NAME M.I. LAST NAME / SUFFIX

New Name on Accounts

FIRST NAME M.I. LAST NAME / SUFFIX

Account Options (Ally Bank only)

Money Market Account:

Ally Financial Inc. Ally Bank, Member FDIC

Signature Verification and Agreement

ACCOUNT OWNER’S PRIOR SIGNATURE DATE

ACCOUNT OWNER’S NEW SIGNATURE DATE

Certification Of Taxpayer Identification Number (Form W-9 or W-8)

Ally Financial Inc. Ally Bank, Member FDIC

Ally Financial Inc. Ally Bank, Member FDIC

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