Transfer
Notice of Stock Donation / Transfer 1) Donor Information Donor Name(s) _______________________________________________ Address
_______________________________________________
City, State, ZIP _______________________________________________ Phone Number _______________________________________________ E-mail
_______________________________________________
2) Donor’s Intent We hereby transfer/gift the following to: Scottrade FBO The Journey Fellowship, Inc. Account # 46297937 DTC # 0705 # of Shares
Name of Stock or Fund
Brokerage Firm
_________
_____________________________
______________________
_________
_____________________________
______________________
_________
_____________________________
______________________
3) Church Location you attend __ Tower Grove
__ Hanley Road
__ West County
__ Metro East
__ Southern Illinois
__ South County
4) Donor Signature(s)
Date
_________________________________________
____________________
_________________________________________
____________________
5) Notes or special instructions_________________________________________________________________ __________________________________________________________________________________________ 6) Final Steps to ensure a successful stock transfer a) Fax a signed copy of this form to your broker. b) Fax a signed copy of this form to Scottrade at (314) 984-8660. Physical shares can be sent to: Scottrade, FBO The Journey Fellowship, Inc. 13275 Manchester Rd #106, St. Louis, Mo 63131 Scottrade phone number (314) 984-0200 c) E-mail a signed copy to the Journey Finance Department at [email protected] d) If you have any questions please e-mail Audrey Van Deraa, Senior Accountant, at [email protected] Note: Due to privacy concerns, your name is not transmitted by the broker to The Journey Fellowship, Inc to identify you as the donor. For The Journey’s Finance office to identify you as the donor for IRS purposes, we rely solely on you e-mailing this form to us at [email protected].
_______________________________________________
City, State, ZIP _______________________________________________ Phone Number _______________________________________________ E-mail
_______________________________________________
2) Donor’s Intent We hereby transfer/gift the following to: Scottrade FBO The Journey Fellowship, Inc. Account # 46297937 DTC # 0705 # of Shares
Name of Stock or Fund
Brokerage Firm
_________
_____________________________
______________________
_________
_____________________________
______________________
_________
_____________________________
______________________
3) Church Location you attend __ Tower Grove
__ Hanley Road
__ West County
__ Metro East
__ Southern Illinois
__ South County
4) Donor Signature(s)
Date
_________________________________________
____________________
_________________________________________
____________________
5) Notes or special instructions_________________________________________________________________ __________________________________________________________________________________________ 6) Final Steps to ensure a successful stock transfer a) Fax a signed copy of this form to your broker. b) Fax a signed copy of this form to Scottrade at (314) 984-8660. Physical shares can be sent to: Scottrade, FBO The Journey Fellowship, Inc. 13275 Manchester Rd #106, St. Louis, Mo 63131 Scottrade phone number (314) 984-0200 c) E-mail a signed copy to the Journey Finance Department at [email protected] d) If you have any questions please e-mail Audrey Van Deraa, Senior Accountant, at [email protected] Note: Due to privacy concerns, your name is not transmitted by the broker to The Journey Fellowship, Inc to identify you as the donor. For The Journey’s Finance office to identify you as the donor for IRS purposes, we rely solely on you e-mailing this form to us at [email protected].
