Date:



|Letter of Authorization – Stock Transfer |

| | | | |

| | | | |

| | | | |

|(Date) | | |

| |

| | | | |

|(Account Representative) | | |

| |

| | | | |

|(Investment CompanyName) | |

| |

| | |

| |

|This is to authorize | |to | |

| |(Investment Company Name) | |

|transfer | |shares of | | | |

| |(Number) | |(Name of Stock) | |(Stock Symbol) |

|held in account # | |in the name of | |

| |(Donor’s Account #) | |(Donor’s Account Name) |

| |

|to the account of Champion Forest Baptist Church, Tax ID # 741727722, Charles |

| |

|Schwab # 2248-0592, DTC # 0164 Code 40, effective the close of business | |

| | | | |

| |. | | | |

|(Date) | | | |

| |

|Please call me at |( ) |or |( ) |if |

| |

|you have any questions. |

| |

|Sincerely, |

| |

| |

| | |

|(Donor’s Signature) | |

| | |

| | |

|Tax Records: | |

| | |

|Number of Shares: | |

|Stock Name: | |

|Stock Symbol: | |

|Effective Date: | |

|Price per Share: | |

|Total Donation: | |

| | |

CC: Champion Forest Baptist Church – Attn: Keith Barbour

................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download