The Twin to Twin Transfusion Syndrome Foundation
"Connecting the World to Fight Twin to Twin Transfusion Syndrome"
 
 

To make a donation of stock to The TTTS Foundation, provide the securities broker who holds your stock with the following letter
  (*fill in the blanks, print out the form, sign at your bank, and send to your broker):

 

 
Date:
To: (Your Brokerage Firm) *
 
Reason: Charitable Donation of Stock

 
I (name of stock owner) * wish to gift to The Twin to Twin Transfusion Syndrome Foundation the securities identified below:
 
The Twin to Twin Transfusion Syndrome Foundation’s Tax ID# (TIN) 34-1740578
 
DTC#: 0226 (National Financial Services)
 
NFS Brokerage Account Number: J9P-018279

 
Please transfer the following securities:
  *Name of Stock:
  *Symbol:
  *Cusip Number:
  *Number of Shares:

 
*Stock Owners Signature_________________________________________________
 
(must be “Signature Guaranteed”-signed in front of bank representative)