Securities / Stock Donation Notification Form
Thank you for donating to the Surfrider Foundation!
Please use this form to notify Surfrider if you are donating shares of a stock, mutual fund, EFT, or bond.
These gifts typically do not come with accompanying information on their own. We appreciate you taking the time to fill out this form with your information so that we will know the securities transfer is from you, so that we can honor you and your intent for the gift, and so that we can be sure to get you a timely tax receipt.
Note that filling out this form alone does not initiate the transfer of the gift. You must request the transfer through your adviser or brokerage/custodian portal.
You may fill out this form before initiating the transfer and then share your copy of it with your advisor, or you may fill it out after the transfer has been initiated.
If you have any questions or concerns, or to request verbal confirmation of our information, please contact us at development@surfrider.org / (949)492-8170x1.
Your Information
First name
Last name
Email
Phone
Mailing Address
Are you the donor?
Yes, I am the donor
No, I am filling this form out on behalf of the donor
Donor's Information
First name
Last name
Email
Phone
Mailing Address
Your Donation
Type of Security
Stock
Mutual Fund
EFT
Bond
Other
Other: please describe
Name of Security
Ticker Symbol
Number of Shares
Estimated $ Value
Name of Brokerage/Custodian
Expected Transfer Date
Standardized Gift Amount
Please note that
the donation will be valued at the average of the high and low on the date of transfer, so your receipt may list a different value that any estimate provided above.
Your Gift Intent
Recognition
You may recognize me/the donor for this gift as listed above.
Please keep this gift Anonymous.
You may recognize me/the donor for this gift, but I/they have preferred recognition name different than my/their name as entered above.
Preferred Recognition Name
Area of Impact
I would like this gift to go to the area(s) of greatest need.
I would like this gift to go to a specific Surfrider program, issue area, geographic area, or chapter.
I would like someone to contact me so I can learn more about where I can have a meaningful impact.
I am paying for an event purchase (ticket, auction item, etc) with this securities transfer.
Please list your intended program, issue, area, or chapter:
Please list the event or item:
Total $ Estimate
Surfrider's Information
The Surfrider Foundation
EIN:
95-3941826
Website:
surfrider.org
Email:
development@surfrider.org
Phone:
(949)492-8170x1
Mailing Address:
PO Box 73550,
San Clemente, CA 92673
Broker:
Charles Schwab
Account Number:
86274387
Schwab DTC Number:
0164
Schwab contact:
James Rangel
Schwab contact phone:
949-348-4182
The Surfrider Foundation is dedicated to the protection and enjoyment of the world’s ocean, waves, and beaches, for all people, through a powerful activist network.
Thank you for supporting our work and for being a friend of the ocean.
Contact Information