Transfer Letter for Securities to Williams College Pooled Income Funds

Securities Transfer Letter for Williams College Pooled Income Fund
INSTRUCTIONS:	Complete this form online, except for signatures and account number. Submit the form. You will receive a confirmation email in a printable format with the DTC information for your broker. Print the email. Sign the printed copy and write in your account number. Send to your broker/banker.

	Note: For transfer of foreign securities, please contact the Trust & Estate Administration Office. (413-597-4533)

I/we confirm that the Trust and Estate Administration Office is expecting this gift. If this is not the case, please notify them at 413-597-4533 or teadmin@williams.edu.

Your email address *

When submitted a printable copy of this form will be sent to this email address

Your broker/banker's name*

Your broker/banker's address*

Address Line 1

Address Line 2

City

State

ZIP Code

Your broker/banker's phone*

Your Account Number

Do not enter your account number on the form, only on the printed copy you fax or mail to your broker/banker.

Your Account Title*

Choose a fund*

Securities Information

Number of shares to transfer*

with a total approximate value of * $

Name of Security/Stock*

Stock Ticker Symbol*

Add a second security?

No Yes

Security #2

Number of shares to transfer*

with a total approximate value of* $

Name of Security/Stock*

Stock Ticker Symbol*

Add a third security?

No Yes

Security #3

Number of shares to transfer*

with a total approximate value of* $

Name of Security/Stock*

Stock Ticker Symbol*

Legal owner(s) of brokerage/bank account *

Date

Securities Transfer Letter for

Williams College Pooled Income Fund

Security #2

Security #3