Sample Stockbroker Authorization Letter

[date]

[your address]

Name of broker or banker
Company name
Address

Dear

I wish to make a gift of [number of] shares of [name of company] common stock to Yeshiva Tiferes Menachem, a nonprofit, tax-exempt charitable organization. Please transfer these shares from my account [# __________ ] to Yeshiva Tiferes Menachem at U.S. Clearing, a Division of Fleet Securities, Inc. through the Depository Trust Company (DTC). The DTC instructions are as follows:

U.S. Clearing, a Division of Fleet Securities, Inc. Contact: Paul D. Schmidt, Senior Financial Advisor
Phone # (800) 233 - 5338
Fax # (718)793 - 5344
Address: 26 Broadway, New York, NY 10004-1798

DTC number: Clearing # 158, Code 40

Credit to: Yeshiva Tiferes Menachem,

Account: 1200774816
 

The tax identification number of Tiferes Menachem is 11-3394709.

If you have any questions regarding this transfer, please contact me or call Yeshiva Tiferes Menachem, 4823 Beach 48th Street, Sea Gate,  NY 11224 at (718) 333-1176.

Thank you for your prompt attention to this matter.

Sincerely,

[your name and signature]

cc: Yeshiva Tiferes Menachem

Attn: Planned Giving
4823 Beach 48th Street
Sea Gate, NY 11224

Fax: (718) 333-2580