Fillable Information On Assets To Be Transferred printable pdf download

DELIVERY INSTRUCTIONS

To the Donor: Complete this form and submit the signed original to your broker or the firm holding your securities. Send a copy of the signed form to the

Program for Charitable Giving, along with the Program Account Form (for a new account) or Adding to a Program Account form (for all established accounts).

To the Broker: Please accept the following instructions as authorization to transfer ownership of the assets specified below to The T. Rowe Price Program

for Charitable Giving Brokerage account.

Information on Assets to Be Transferred

SECTION I

This form is to be used when donating

TRANSFER-OF-OWNERSHIP INSTRUCTIONS:

stocks or closed-end mutual funds held at

a financial institution other than T. Rowe

NAME OF THE BROKER OR FIRM HOLDING YOUR SECURITIES:

Price. When completed and signed, this form

ADDRESS:

will serve as your transfer instructions to the

broker or firm holding the securities you wish

to donate to The T. Rowe Price Program for

Charitable Giving.

CITY/STATE/ZIP:

If you have questions or would like assis-

tance in completing this form, please

CONTACT NAME:

DAYTIME PHONE:

contact a service associate by calling

1-800-690-0438.

ACCOUNT NUMBER:

I f you need additional forms, please call

Check ONE of the following:

1-800-690-0438 or visit our website at

M I f your account is with Deutsche Bank Alex. Brown; E*Trade; Charles Schwab & Co., Inc.;

Morgan Stanley Smith Barney LLC; or TD AMERITRADE, your broker can transfer securities

directly into a T. Rowe Price Program for Charitable Giving Brokerage account. Account

M C heck here to indicate you have

numbers are provided in Section IV on the back of this form.

sent the completed Delivery

T ransfer the securities to The T. Rowe Price Program for Charitable Giving account at

Instructions form to your broker or

the firm holding your securities.

_____________________________________, account #____________________________.

M T ransfer the securities to The T. Rowe Price Program for Charitable Giving Brokerage account

If your shares are held by a financial

at Pershing LLC, a subsidiary of the Bank of New York Mellon Corporation, member NYSE/

institution acting as the transfer agent,

FINRA/SIPC (DTC#0443, Account #30B806278).

please see instructions in Section IV.

Important: Securities should be transferred in kind and are not to be liquidated.

Name of Security

Number of Shares

Signatures

SECTION II

This section must be signed by all registered owners of the assets to be donated.

M ake sure all registered owners of the

assets to be donated sign the Delivery

I (We) hereby irrevocably and unconditionally transfer ownership of the assets listed above to

The T. Rowe Price Program for Charitable Giving.

Instructions form.

S end the signed original form to the

broker or firm holding your securities.

ACCOUNT OWNER OF ASSETS LISTED ABOVE

SOCIAL SECURITY NUMBER

S end a copy of the signed Delivery

Instructions form, along with the Program

SIGNATURE

Account Form (for a new account) or

Adding to a Program Account form

JOINT ACCOUNT OWNER OF ASSETS LISTED ABOVE

SOCIAL SECURITY NUMBER

(for all established accounts), to:

The T. Rowe Price Program for

SIGNATURE

Charitable Giving

Most brokerage firms require a signature guarantee. Please complete Section III on the back of this

P.O. Box 17115

form unless otherwise instructed by your broker.

Baltimore, MD 21297-1115

rogram

iving

org

Information On Assets To Be Transferred

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