Stock Transfer Notification Form

Thank you for your interest in completing this notification form to let The Salvation Army Great Lakes Division know of your intent to transfer a gift of stock. You will be required to initiate the transfer with your broker and complete any necessary forms with your financial institution.

* Required fields

Personal Information

Donor Name

Address

Phone

How Would You Like Your Gift to Impact?

Greatest need

Other (Please describe)

Option 2

Option 3

Option 4

Option 5

Choose a Gift Type

Stock

Mutual Fund

ETF

Gift of mutual form opened below

Gift of stock form opened below

For gifts of stock:

Broker Name

Broker's Institution

Broker's Phone

Broker's Email

Stock Name/Ticker Symbol

Number of Shares

Expected Date of Transfer

For gifts of mutual fund:

Please contact us for more information on a transfer of mutual funds. We will do our best to assist you with instructions for this gift.

Name of Mutual Fund:

Organization's Information

Organization's Legal Name:

Organization's Tax ID:

Organization's Address:

Organization's Email:

Organization's Phone Number:

Organization's Broker Institution:

Organization's Broker Institution Address:

Organization's Account Name:

Organization's Brokerage Account Number:

Organization's Electronic Transfer Number (DTC):

Instructions for physical shares by insured certified mail - If you hold securities in certificate form, you will need to mail two envelopes separately to complete your gift. In the first envelope, place the unsigned stock certificate(s). In the other envelope, include a signature guaranteed stock power for each certificate. You may obtain this form from your broker or bank. Please remember to use insured certified mail.

Please note: This notification form is not a receipt for your charitable donation. We will send you an acknowledgement after we receive your gift. The value of a charitable gift of stock, mutual fund, ETF or other security is determined by the average of the high and low stock price on the date we receive your securities. Consult your financial institution or professional advisors for more information on the timing of the transfer.

A Legacy of Giving