Stock Gift Letter of Intent

Please complete this form prior to transferring the gift so that we can identify and apply your gift properly.

First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.

Address REQUIRED Please fill out this field.

City REQUIRED Please fill out this field. Please enter valid data.

State REQUIRED Please fill out this field.

Zip REQUIRED Please fill out this field. Please enter a zip code.

His or Her Email

Email REQUIRED Please fill out this field. Please enter an email address.

His or Her Phone Number REQUIRED Please fill out this field.

Phone Number REQUIRED Please fill out this field. Please enter a phone number.

Parish Affiliation Please enter valid data.

Estimated # of shares: REQUIRED Please fill out this field. Please enter valid data.

Name of Stock REQUIRED Please fill out this field. Please enter valid data.

Ticker symbol Please enter valid data.

Approximate value of stock/mutual fund REQUIRED Please fill out this field. Please enter valid data.

Please apply my gift to the following fund(s) REQUIRED Catholic Services Appeal (CSA) Capital Campaign Cedarbrake Catholic Charities of Central Texas Parish (please fill out section below) School (please fill out section below) Other (we may contact you for further clarification) Please fill out this field.

If donating to one or more parishes, please fill out details below:

Select Options Below: Parish Offertory Parish Capital Campaign Other
Parish Designation:
Only fill out if donating to a parish or school

If donating to one or more schools, please fill out details below:

School Designation:
Only fill out if donating to a parish or school

To be credited to the Catholic Diocese of Austin [Tax ID #74-1542827] for the benefit of: REQUIRED Please fill out this field.

Additional Comments:

Please provide this information to your broker:

Catholic Diocese of Austin
Tax ID: 74-1542827
Account Name: Diocese of Austin Endowment Gift Account
Receiving Firm: US Bank
Account number: 5003050-008
DTC: 2803

Thank you for your generosity to the Diocese of Austin!