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Donor Name __________________________________________________________________Address _______________________________________________________________________Phone:_____________________ Email _____________________________________________Broker Name: __________________________________________________________________Address: _______________________________________________________________________Phone:_____________________ Email _____________________________________________Dear Broker,Please accept this letter as authorization to irrevocably transfer _________________ shares of _______________________________ from my ____________________________ account. My account is in the name of ___________________________________________________ . The account # is _____________________, and my Social Security # is ________________. Please transfer to:DTC# 0062 Vanguard – Acct # 78515793Vanguard brokerage account and VIAS plan name: Barre Center for Buddhist StudiesTax ID Number: 22-3058493Donor Signature ________________________________________Date __________________Please notify BCBS when a donation transfer is initiated and to get Vanguard account number. Contact:Richard Henning, Executive DirectorBarre Center for Buddhist Studies149 Lockwood Road, Barre MA 01005Phone: 978-355-2347 ext. 21; Fax: 978-355-2798; Email: richardh@Thank you for your generosity. Your contribution will support BCBS in its mission to explore Buddhist thought and practice as a living, transformational tradition. ................
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