The butterfly counts not months but moments, and has time enough. Rabindranath Tagore
Idea Transcript
Securities Transfer Form To be completed by Donor: Name of Donor: ____________________________ Day time telephone:___________________ Address of Donor: ________________________________________________________ Delivering Institution: ______________________________________________ Address of Delivering Institution: _____________________________________ Account # at Delivering Institution: ____________________________________ Name of Security: ______________________ # of shares:_________________________ Approximate Value of each share: $_________ Approximate Total Value: $_____________ Date of Transfer to Siloam Mission’s Account: ___________________________ This letter will serve as your authorization to release the securities noted above to the account of Siloam Mission Inc. I understand that I will receive a Gift-In-Kind tax receipt from Siloam Mission Inc. within approximately 2 weeks, for the closing price of these securities on the date of transfer to Siloam Mission Inc.’s account at CIBC Wood Gundy (711 079 77). These securities have been donated to Siloam Mission Inc. without restriction and can be sold by Siloam Mission Inc. at any time. __________________________________ Signature of Donor