AFW Stock Donation Notification Form

STOCK GIFT NOTIFICATION FORM
To ensure that your gift is processed accurately, please complete the information below.
This form will notify Angel Flight West of the impending gift. For any questions, please contact us at donate@angelflightwest.org

Angel Flight West Inc. | Tax ID/EIN# 95-3956297
NAME & TYPE OF SECURITIES
Stock Name*
Security Symbol*
# of Shares*
Stock Transfer Date:
Gift Designation / Restriction (if any)
Additional instructions/comments
DONOR INFORMATION

Information will be used to mail out acknowledgment letter upon receipt of gift
Donor Name

First NameLast Name
Check here to be an anonymous donor

I would like to be listed as anonymous
Donor Company
Donor E-mail
example@example.com
Donor Phone Number
BROKER INFORMATION
Broker Company
Broker Name

First NameLast Name
Broker City and State

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Please consult with your tax advisor before making a charitable donation to any charity. You may be eligible to increase the power of your donation with employer matching funds. Many employers will match your personal donation. Check with your company for more information on matching gift programs.

Employer matching gifts may also be available to you if you are the spouse of an employee, a retired employee, or the spouse/widow/widower of a retiree.
Should be Empty:

STOCK GIFT NOTIFICATION FORM