University of the Pacific School of Dentistry
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University of the Pacific Arthur A. Dugoni School of Dentistry
Gifts of Stocks, Bonds, Mutual Funds and Other Securities
To make a gift of stock or securities transfer them to the “University of the Pacific Arthur A. School
of Dentistry” (Tax ID# 94-1156266).
I-a. The simplest way to make your gift is to instruct your broker to electronically transfer the
number of shares you wish to donate to our account listed below. Our broker is instructed to sell all
gifted securities immediately. Our receipt, for your tax records, will be based on the average of the
high and low sales price of your stock on the day the transfer was made.
Our Broker is: Our Account Number is:
Mr. Larry Watts DTC #: 0201
A.G. Edwards & Sons, Inc. Acct#: University of the Pacific,
Brookside Business Park Arthur A. Dugoni School of
3203 W. March Lane Dentistry/6242-8725
Stockton, CA 95219
Voice: 209-957-8100
I-b. If you have the actual certificates, please call for instructions.
II. Important: use the “FAX-BACK Information Form” on the reverse
side to tell us of your gift and provide your instructions for its use.
THANK YOU!
If you have questions about making your stock transfer, please call our broker. For questions about
making a gift to Pacific, contact any one of the following:
Dr. Berney Neufeld, Director of Development – 415-929-6402; bneufeld@ pacific.edu
Ms. Ann Cisneros, Planned Giving Officer – 415-929-6432, acisnero@ pacific.edu
Ms. Mary Flaherty, Senior Gift Officer – 415-929-6606; mflaherty@pacific.edu
Berney, Ann or Mary may be reached by fax at: 415-929-6455
Dugoni School of Dentistry – revised 12-06
University of the Pacific Arthur A. Dugoni School of Dentistry
Gifts of Stocks, Bonds, Mutual Funds and Other Securities
FAX-BACK Information Form
FAX To: Institutional Advancement
415-929-6455
I/We have instructed my broker to transfer __________ (number of shares) of
___________________/__________ (name of stock and stock symbol) to
University of the Pacific’s account at A. G. Edwards & Sons, Inc, Stockton
(attn: Mr. Larry Watts).
I/We would like this gift to be used to for:
_________________________________________________________
(e.g. Dean’s Fund for Excellence, unrestricted, Classroom Campaign, scholarships, Named
Endowment, etc).
Notes:
Name_________________________Date__________
(please print)
Signature___________________________________
Phone Number______________________________
Dugoni School of Dentistry – revised 12-06
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