Securities Donation Notification

Securities Donation Notification

To be completed by donor when donating a stock or mutual fund.
Todays Date*

MonthDayYear
Donor's Name*

First NameLast Name
Joint Donor's Name, if applicable

First NameLast Name
Donor's Email*
example@example.com
I (we) freely donate to First Free Church*
I (we) would like to designate the gift as follows (enter percent or amount):*
Transfer of shares to Charles Shwab and Co, DTC #0164, FBO First Evangelical Free Church of St. Louis County, Account #3415-0821, was requested on:

MonthDayYear
Date
Please add any comments or additional instructions below:
If you would like your broker or financial advisor to receive a copy of this form submission, please enter their email below.
example@example.com
If you have any questions, please contact the First Free Contributions Manager at giving@efree.org or 636-779-2193.
Should be Empty: