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Securities Gift

Thank you for your support with a gift of securities to the Armed Services YMCA

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Securities Information

Name & Type of Securities*

Number of Shares*

Date of Transfer*

Donor's Information

Donor's Name*

First Last

Donor's Address*

Billing Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Donor's Phone Number*

Donor's Email*

Broker's Information

Broker's Name*

First Last

Broker's Company Name*

Broker's Phone Number*

Acknowledgement

Important Information About Your Gift*

After Armed Services YMCA receives this form and our broker confirms the donation of securities, the development staff will issue an official acknowledgment letter to the donor. This letter will indicate the number and type of shares received and date the stock was converted into a gift (day when record ownership of stock was transferred to Armed Services YMCA or the stock was unconditionally delivered to Armed Services YMCA).

All contributions are tax-deductible to the fullest extent provided by law. Every effort will be made to sell non-marketable securities as quickly as possible. For tax purposes, the value of the stock will be an average of the high and low prices on the date of the gift. The donor should be aware of possible tax implications. Please contact your tax advisor for complete tax deductibility rules.

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