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Stock Gift Electronic Transfer
Online Submission Form
For outright gifts/bequest gifts only - not for planned gifts
Please instruct your broker to transfer DTC-eligible shares to the following account:
Bank: Wells Fargo Clearing Services – Jeanne M Campbell (703) 673-7044.
DTC #: 0141
Account #: 7911-0564
Reference: Land Trust of Virginia (Tax ID# 54-1601471)
Important: You must notify the Land Trust of Virginia when you make a gift of stock. Your notification is the only way we can identify your gift when it is received. Please return this form using the instructions above, or call Sally Price at (540) 687-8441; email:
sally@landtrustva.org
Upon confirming the transfer, LTV will provide you with a formal tax receipt of your contribution.
THANK YOU FOR YOUR GIFT!
Donation and Transfer Information
Who Owns Title to the Stock
*
First Name
Last Name
Donor(s) Name
First Name
Last Name
Address
*
Address Line 1
Address Line 2
City
City
State
State/Province
ZIP/Postal Code
Email
*
Verify Email
*
Phone
Name of Stock:
Number of Shares:
Approximate Value:
Have you owned these shares for a least one year?
yes
Delivering bank or brokerage and DTC:
Broker Name:
Broker Phone Number: