Stock Gift Form

PSU Foundation Stock Gift Form
Please complete this form to notify the PSU Foundation of your planned transfer of securities from your brokerage firm. After submission, you will have the option to print this form with transfer instructions to provide to your broker to help initiate your stock gift transfer. Your brokerage firm may also require additional forms or documentation to complete the transfer.

Once the transfer has been received, you will receive a tax receipt providing the date of receipt, description of the securities, number of shares. If you have questions about the transfer process, you may contact stockgift@psuf.org.

Brokerage Account Information
- Stock and Mutual Funds
  U.S. Bank
  DTC #2803
  For credit to: Account # 19-520602 PSU FDN STOCK GIFTS
- Fed-eligible securities
  Federal Reserve Bank of Ohio
  For: U.S. Bank, N.A., Trust
  ABA 042-000-013
  1050/TRUST
  For Account Number: 19-520602
Donor Information
Donor Name(s)
I wish for this gift to be anonymous:
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email
Required if you would like to receive a copy of this form.
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Designation Information
Should this gift be applied to an open pledge?
Please designate my gift to the following Program, School, or Fund at PSU
Stock Information
Stock Information
Authorization
By signing here you authorize the transfer of this stock to PSU Foundation.
Signature
Instructions for transferring securities to PSU Foundation:

Stock and Mutual Funds
U.S. Bank
DTC #2803
For credit to: Account # 19-520602 PSU FDN STOCK GIFTS

Fed-eligible securities
Federal Reserve Bank of Ohio
For: U.S. Bank, N.A., Trust
ABA 042-000-013
1050/TRUST
For Account Number: 19-520602
Should be Empty:

PSU Foundation Stock Gift Form

Donor Information

Designation Information

Stock Information

Authorization