Bull, Morreale & Judelson, P.C.
90 Crystal Run Road
Suite 404
Middletown, New York 10941
Telephone No.: (845) 695-2002
Fax No.: (845) 695-2902
Contact Us

[Your Name]
[Your Address]

[Date]

[Your Broker's Name]
[Your Broker's Address]

Account No [Insert Your Account No.]

Dear:

This is to confirm my request and direction that upon receipt of this letter, you immediately transfer the below indicated securities owned by me to account number xxxxx at [insert name of brokerage firm for charity]:*

[Insert number of shares and name of securities]

Please acknowledge receipt of this letter by returning a copy to me. On the copy of the letter, please indicate the high and low selling price for the securities on the date of your receipt of this letter and the average of these two prices.

If you have any questions, please contact me or contact the office of the [insert name of charity] at [insert telephone number of charity].

Sincerely yours,

[Your Name]

cc: [insert name and address of charity]

*In the alternative, if your broker has or desires to establish an account in the name of the charity, you may have your broker transfer the securities into an account with your broker in the name of the charity.