Stock Donation Letter Template by cometjunkie46



  Floresta USA Inc
  Attn: Kristen Tucker
  4903 Morena Blvd, Ste 1215
  San Diego, CA 92117

  RE: Notice of Pending Gift of Stock

  Dear Floresta USA,

  I am writing to inform you that I have made a gift of securities to Floresta’s brokerage
  account at UBS Financial Services. Please use the following information for your

  My Name: ______________________________________________________

  Stock Name: ____________________________________________________

  Number of Shares: _________________

  Date of Expected Transfer: ____________________________________

  My Broker’s Name and Phone Number: ____________________________________

  Please designate my gift toward the following areas:                      Where Most Needed
                                                                            Other: ___________________
                                                                                             (please specify country)

  I would like my gift to remain anonymous.  Yes  No  No Preference

  I acknowledge that the shares will be transferred to Floresta USA’s brokerage account
  and that Floresta will provide me with an in-kind receipt. I also understand that Floresta
  maintains complete discretion and control over the use of all donated funds.


(If you are emailing this letter, please type your name in
the box above; if you are mailing or faxing, please print
this page out then sign your name in the box above)

Send form to: ATTN Kristen Tucker, 4903 Morena Blvd Suite 1215, San Diego, CA, 92117 Fax: (858) 274-3728 Email:

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