Contribution Notification Form

for publicly traded securities

a person sitting at a desk holding a pen, with papers and a computer on the desk

This form is to notify The Signatry of your intention to make a gift of a publicly traded security and to provide us with tracking information. It does not initiate the gift. Without the information on this form, we may not be able to place your contribution in the intended fund when we receive it. If you need assistance with the application, please email our team or call (913) 310-0279.

If you prefer to use a PDF version of the form, you can download it here and email a completed copy to our Donor Care team.

After completing the form, direct your broker to contribute the securities through:

Charles Schwab and Company
DTC 0164, Code 40
Account Name: The Signatry
Account Number: 9511-3100

This account number must be entered exactly. If the number is not an exact match, Schwab will accept the stock but will not be able to direct it to The Signatry, and it will take up to 3 business days for Schwab to return the securities to you. You can confirm receipt of contributed securities by contacting our Donor Care team.

Fields marked with an asterisk are required.

Fund Information

Fund Name or ID of the fund you are intending to contribute to:*

Are there investments in this DAF managed and custodied by a licensed financial advisor, wealth manager, Registered Investment Advisor (RIA), or family office in an external fund?*

Contributor Information

Which of the following best describes your role in this contribution?*

I am the primary contributor (the person being receipted for the gift)
I am representing the primary contributor

Provide the following information for the primary contributor (the person being receipted for the gift)

First Name*

Last Name*

Email*

Phone Number*

Street Address*

City*

State*

Postal Code*

Contribution Details

Please complete the following information regarding your intended contribution so that we can identify your gift when it is transferred to The Signatry. If you intend to transfer more than 3 securities, please fill out the attached spreadsheet and submit it to our Donor Care team at donorcare@thesignatry.com. Once you have completed this form, instruct your advisor or broker to initiate the gift

Note: Securities cannot be held at a third-party transfer agent such as Computershare, EQ Shareowners, etc.

Name of Security Issuer*

Expected Transfer Date*

SECURITY #1

Security Name*

Ticker/CUSIP*

# of Shares*

Expected Value ($)*

SECURITY #2

Security Name

Ticker/CUSIP

# of Shares

Expected Value ($)

SECURITY #3

Security Name

Ticker/CUSIP

# of Shares

Expected Value ($)

For securities being transferred to The Signatry's main account (not to an Advisor Managed Account), contact your broker to initiate the transfer. Information about where to direct your transfer will be provided once you complete this form.

Note: Securities received into The Signatry's main account will be liquidated on receipt, and the proceeds will be transferred into the fund you have indicated on this form. If you do not wish to liquidate or want to transfer the securities in-kind, please direct to your advisor or custodian instead.

Note: The financial institution holding the securities may require the use of its own form or letter of instruction. Please check with the firm to see what additional forms they require. If the securities are not transferrable, notify The Signatry that the intended gift will not be completed.

Acknowledgement

I understand and acknowledge that this form cannot be used to transfer property to The Signatry. Any contribution should be coordinated with my financial institution, broker or advisor, and any contribution, once accepted by the fund, represents an irrevocable contribution to The Signatry and is not refundable to me for any reason.

Your Printed Name

Date of Acknowledgement

Funds held at The Signatry are property of The Signatry and are subject to The Signatry's exclusive legal control. Grant funds can only be used for charitable purposes and may not be used to benefit the donor, the donor advisor, nor any other purpose conferring to an impermissible private benefit.

Please provide any final questions or comments before submitting: