Irrevocable Stock/Bond Power Form
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Irrevocable Stock/Bond Power Form Please return completed form to Sarah A. McManus, Director, Development Email: [email protected] Mail: Cincinnati Therapeutic Riding and Horsemanship, 1342 US Hwy 50, Milford, OH 45150 * Important: to ensure Cincinnati Therapeutic Riding and Horsemanship can identify and acknowledge your gift, especially for tax purposes, please complete and return this form in advance of the stock transfer. Donor Information: Contact Name(s): Organization, if applicable: Preferred Name(s) for Recognition Purposes: Address: City: State: Zip: Phone: Phone Type: □ Home □ Cell □ Business Email: Email Type: □ Home □ Business Signature (must match name on stock/bond): Date: Stock/Bond Details: Name of Stock/Bond: Symbol: Approx. Total $ of Transfer: Number of Shares/Bonds to be Transferred: Approx. Date of Transfer: Certificate Number(s): Brokerage Name: Brokerage Contact Name: Phone: Email: Attorney, if applicable: Phone: Email: Gift Information: My company, , has a matching gift program, and I have requested a match. □ I / We have included Cincinnati Therapeutic Riding and Horsemanship in my/our estate plans. □ I / We would like to learn more about planned giving opportunities to benefit inclusive horsemanship. □ I / We are interested in volunteering at Cincinnati Therapeutic Riding and Horsemanship. Please contact me/us. □ I / We would like to remain anonymous. Tribute Gift: This gift is □ in honor of □ in memory of Please notify: Name(s): Address: City: State: Zip: DTC Instructions for Cincinnati Therapeutic Riding and Horsemanship: Contact: Sarah A. McManus, Director, Development, Cincinnati Therapeutic Riding and Horsemanship (513) 831-7050, [email protected] Financial Institution: Peter S. Hiltz, AAMS,Partner, Wealth Manager, Kingsview Partners (513) 401-8513, [email protected] Account Details: DTC Clearing: 0164, Code 40 Account Number: 2989-8983 Account Title: Cincinnati Therapeutic Riding and Horsemanship Short Term Cash Account Clearing House: Charles Schwab & Co. see reverse side for additional information
Transcript of Irrevocable Stock/Bond Power Form
Irrevocable Stock/Bond Power Form Please return completed form to
Sarah A. McManus, Director, Development Email: [email protected]
Mail: Cincinnati Therapeutic Riding and Horsemanship, 1342 US Hwy 50, Milford, OH 45150
* Important: to ensure Cincinnati Therapeutic Riding and Horsemanship can identify and acknowledge your gift, especially for tax purposes, please complete and return this form in advance of the stock transfer.
Donor Information:
Contact Name(s):
Organization, if applicable:
Preferred Name(s) for Recognition Purposes:
Address:
City: State: Zip:
Phone: Phone Type: □ Home □ Cell □ Business
Email: Email Type: □ Home □ Business
Signature (must match name on stock/bond): Date:
Stock/Bond Details:
Name of Stock/Bond:
Symbol: Approx. Total $ of Transfer:
Number of Shares/Bonds to be Transferred: Approx. Date of Transfer:
Certificate Number(s):
Brokerage Name:
Brokerage Contact Name:
Phone: Email:
Attorney, if applicable:
Phone: Email:
Gift Information:
My company, , has a matching gift program, and I have requested a match. □ I / We have included Cincinnati Therapeutic Riding and Horsemanship in my/our estate plans. □ I / We would like to learn more about planned giving opportunities to benefit inclusive horsemanship. □ I / We are interested in volunteering at Cincinnati Therapeutic Riding and Horsemanship. Please contact me/us. □ I / We would like to remain anonymous.
Tribute Gift:
This gift is □ in honor of □ in memory of Please notify: Name(s):
Address:
City: State: Zip:
DTC Instructions for Cincinnati Therapeutic Riding and Horsemanship:
Contact: Sarah A. McManus, Director, Development, Cincinnati Therapeutic Riding and Horsemanship (513) 831-7050, [email protected]
Financial Institution: Peter S. Hiltz, AAMS,Partner, Wealth Manager, Kingsview Partners (513) 401-8513, [email protected]
Account Details: DTC Clearing: 0164, Code 40 Account Number: 2989-8983 Account Title: Cincinnati Therapeutic Riding and Horsemanship Short Term Cash Account Clearing House: Charles Schwab & Co. see reverse side for additional information
