Lever Foundation



[DATE][BROKER NAME][BROKER ADDRESS]Dear Broker,The purpose of this letter is to instruct you to transfer [NUMBER] shares of [STOCK NAME], [COMMON OR PREFERRED] from my account, [ACCOUNT NUMBER].This transfer constitutes a charitable gift to the Lever Foundation, federal tax identification number 82-3445472. Please transfer these shares as soon as possible to Fidelity Investments brokerage account Z50792381, DTC #0226. Should it be needed, Fidelity Investments’ mailing address is: Fidelity Investments, Attn: TOA Receives, PO Box 770001, Cincinnati, OH 45277-0036The Lever Foundation’s authorized individual and contact information are as follows:Nick CooneyLever Foundation, Inc.PO Box 715Lancaster, PA 17601(484) 904-6004nick@Thank you for your assistance. I look forward to your written confirmation of the completion of this transfer.Sincerely,[SIGNATURE][NAME] [ADDRESS] ................
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