Gifts of Securities Form

(Note: Complete this form and click on the review button at bottom. You will be able to review the completed form before it submits.)

* Required Information

Donor Information

* Name:  
* Address:  
* City:   * State:   * Zip:  
* Phone:   * E-mail Address:  

Security Information

* Type of Security:   * Name of Security:  
* Quantity: Number of Shares   * Approx. Stock Value: $  
* Delivering Broker:  
* Broker Address:  
* Broker Contact Name:  
* Broker Phone:   Broker E-mail Address:
 

Gift Designation

(If no designations are specified, funds will be applied to the Lottie Moon Christmas Offering, which funds all missions ministries of the IMB.)

Designate your gift to any category below

Lottie Moon Christmas Offering
Amt: $ Percent (%):
Amt: $ Percent (%):
Lottie Moon Challenge
Amt: $ Percent (%):

Amt: $ Percent (%):
World Hunger & Relief
Amt: $ Percent (%):

Amt: $ Percent (%):
Special Gift for
Amt: $ Percent (%):

Amt: $ Percent (%):
Other Designations/Endowments/Annuities
Amt: $ Percent (%):