Stock Transfers

Stock transfers to PIH arrive with no accompanying donor information. In order for us to identify your gift and issue a tax receipt, please provide us with the following information.

Transfer instructions will be emailed to you upon submission of this form. Please check your junk mail folder if you do not see it in your inbox.

Country

First Name

Last Name

Address for Acknowledgment Letter*

Address for Acknowledgment Letter*
	Address for Acknowledgment Letter*	Item weight

more items

City

State/Region/Province*

Zip/Postal Code

Phone

Transfer Date

Broker/Financial Office Contact Name

Broker/Financial Office Contact Phone#

Type of Stock

Number of Shares

Estimated Gift Value (in USD)

Your Brokerage Firm

Transfer instructions will be emailed to you upon submission of this form. Please check your junk mail folder if you do not see it in your inbox.

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Please send donations to: Partners In Health, PO Box 996, Frederick, MD 21705-9942