You may copy this form to your email or Word Processor. Just replace the blue content with your own information and send a copy to your broker and inform EBJC to expect your contribution.
My City, State Zip Code
My Broker’s Name
My Broker’s Address
My Broker’s City, State Zip Code
Please transfer Number of Shares of My Stock Name from My Account (00000-00000-00) to:
Muriel Siebert & Co
FBO: EAST BRUNSWICK JEWISH CENTER
ACCOUNT # CXT542100
I am making a charitable contribution and I understand that I will lose ownership of these shares.
Please let me know when this transaction is complete and/or if you have any questions please feel free to call me at My Phone Number: (xxx) xxx-xxxx or My Email (email@example.com).