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Stock Transfer

Charitable Stock Transfer Form

Please complete this form to tell us that you have initiated a stock transfer with your broker as a gift to Fidelco Guide Dog Foundation.

Upon submission, you will receive an email with the information provided to pass on to your broker.

For electronic transfers, transfer to:

Charles Schwab DTC
Clearing #0164, Code 40
FBO: Fidelco Guide Dog Foundation, Inc.
A/C # HT3268-9509

Donor Information
Name*
First Last
Address*
Street Address Address Line 2 City State ZIP Code
Phone*
Email*
Broker & Account Information
Broker Name*
First Last
Brokerage Firm*
Name of Stock*
Number of Shares to Be Donated*
Estimated Amount of Donation*

If you would like to complete the form manually, please select the PDF below and email a copy to info@fidelco.org or mail a copy to:

Fidelco Guide Dog Foundation
Attn: Diane Lindeland
103 Vision Way
Bloomfield, CT 06002

PDF Charitable Stock Transfer Form

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