GIFT OF SECURITIES
Authorization and Direction Form

To read Vancouver Foundation’s disclaimer regarding Valuation and Timing, please click here to open them in a new tab.

This form confirms your wish to donate securities currently owned by me/us from my/our account (listed below) to Vancouver Foundation account # 80536947-10 at BMO Nesbitt Burns. I/We further authorize the delivering institution to discuss the details of this transfer with BMO Nesbitt Burns, in order to facilitate this request.

My Investment Account Number

Gift Type (Please click on the appropriate button below for your choice.)

Specific Number of SharesApproximate Dollar Amount

Specific Number of Shares

Name of Security

Ticker Symbol

Type of Security

Number of Shares

Approximate Dollar Amount

Name of Security (if known)

Ticker Symbol

Type of Security

Approximate Dollar Value

Firm Type

Financial AdvisorSelf Directed

Financial Advisor Contact Information

First Name

Last Name

Firm

Phone

Donation Anonymous

Would You Like Your Donation to be Anonymous?

Yes

In order to properly recognize all donors for their contribution, Vancouver Foundation will share your name, donation amount and contact details with the fund advisor unless you have checked “Yes” to the anonymous box above.

Fund Contribution Information

It is my/our understanding that the tax receipt will generally be issued based on the last quoted trading price during normal trading hours on the date that the securities are received into Vancouver Foundation’s account.

It is also my/our understanding that the above securities will be offered for sale as described in Vancouver Foundation guidelines and the net sale proceeds will be credited to the following fund at Vancouver Foundation.

Fund Name

Please start typing to search. If Fund is not found continue typing the name to add it.

For this donation how would you like your gift allocated?

Capital Contribution – your donation will be invested, to generate ongoing distributions for granting.Flow Through – your donation will not be invested, but rather available for immediate granting.

Donor 1 Information

Check if this gift is from a corporation

Corporation Name

Authorized Representative

First Name	Last Name
Email	Street Address
Country	City
Province	Postal Code Example: V1V 1V1
State	ZIP Code

Donor 2 Information

First Name	Last Name
Email	Country
Street Address	City
Province	Postal Code Example: V1V 1V1
State	ZIP Code

Signer Info

Signer

Sign Date

*CUID: NTDT | DTC: 5043 | Mutual Fund Donations Dealer Code: 9185 | Mutual Fund Rep. Code: U2M

Charitable Registration No. 11928 1640 RR0001

Vancouver Foundation | www.vancouverfoundation.ca | T 604.688.2204

Contact Information

GIFT OF SECURITIESAuthorization and Direction Form

GIFT OF SECURITIES
Authorization and Direction Form