Notification Letter for Transfer of Stock
3850005-28575100Notification Letter for Transfer of Stock(Please complete and forward to BMO and CFSW)Date: FORMTEXT ?????Broker Name: FORMTEXT ?????Brokerage Firm: FORMTEXT ?????Address: FORMTEXT ?????City: FORMTEXT ?????State: FORMTEXT ?????Zip: FORMTEXT ?????Phone: FORMTEXT ?????RE: Gift of Stock to Community Foundation of Southern WI, Inc.Dear REF Broker \* MERGEFORMAT ,This letter constitutes my direction to you to transfer the following shares of stock from mybrokerage account # FORMTEXT ?????to the Community Foundation of Southern WI, Inc.Number of Shares: FORMTEXT ????? Name of Stock or Mutual Fund: FORMTEXT ?????Number of Shares: FORMTEXT ????? Name of Stock or Mutual Fund: FORMTEXT ?????Number of Shares: FORMTEXT ????? Name of Stock or Mutual Fund: FORMTEXT ????? FORMCHECKBOX I have added a separate sheet listing additional stocks to be transferred. I intend this transfer to be a gift to the fund named FORMTEXT ?????held at the Community Foundation of Southern Wisconsin, Inc.Name: FORMTEXT ????? Address: FORMTEXT ?????Signature: City: FORMTEXT ?????State: FORMTEXT ?????Zip: FORMTEXT ?????Delivery Instructions/Regular Stock OnlyF/C AccountCommunity Foundation Contribution AccountF/C Account Number41-J004-02-2BMO Harris Bank N.A.DTC Participant #992Please Contact: Jennifer Schneider BMO Harris Bank 608-232-2012 ORPeggy Dimitrakakis BMO Harris Bank 414-287-8606For Certificates of Stock and Mutual Funds contact Jennifer Schneider (above) for instructions.2887980130175Visit: 121 N. Parker Dr. Janesville, WI 53545 Email: info@ Phone: 608-758-0883 00Visit: 121 N. Parker Dr. Janesville, WI 53545 Email: info@ Phone: 608-758-0883 Mail: Community Foundation of Southern Wisconsin, Inc.Attn: President/CEOP.O. Box 8125Janesville, WI 53547-8125 ................
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