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Stock and Securities Donation 

1. For stock and securities donations, please print out this page or download the PDF form. Fill out the form and give it to your broker, or contact our office at (646) 742-0200, or email us at .

2. Please ask your broker to fax a copy of these stock donation instructions to us at (212) 779-8044. In order for Blacksmith Institute to confirm the receipt of your stock gift, please include on the instructions your name, address, telephone number, and e-mail address. 

Brokerage Firm: ________________________________
Broker: ________________________________
Address: ________________________________
Re: Account #: ________________________________
Account Title: ________________________________

Dear Broker:
Please accept this letter as authorization to gift:

_________ shares of _____________________ stock to:

Blacksmith Institute, a 501(c)(3) public charity
DTC number: 0418
Account number: 117-16541-12-009

Thank you for your immediate attention to this matter.


Signature of gifting share holder (donor)

PS: Please provide us with contact information for acknowledgment.
Donor name: ___________________________
Address: ___________________________
Phone: ___________________________
Fax: ___________________________
Email: ___________________________

* All contributions are tax-deductible as allowable by law. Blacksmith Institute is a registered 501 (c) 3 and a recognition letter/receipt will be sent following all contributions.