Gift of Stocks or Securities

Stock or securities transfers to Adventist Health Central Valley Health Foundation arrive with no accompanying donor information. In order for us to identify and properly acknowledge your gift, please complete the form below. In the event you have already transferred stocks or securities and have not been acknowledged, please complete the form below to alert our team of your gift.

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Donor Information

Untitled

I/we prefer this gift to be anonymous.

Donor Name*

Title First Last

Spouse/Partner Name

Title First Last

Email*

Phone

Mailing Address*

Address Line 1 Address Line 2 City State / Province / Region ZIP / Postal Code

Please designate my gift to*

Other designation

Stocks/Securities Information

Transfer Date*

Brokerage Name*

Broker/Financial Office Contact Name*

Broker/Financial Office Phone Number*

Type of Stock (Name/Symbol)*

Number of Shares*

Estimated Value*