Securities Form - ECMI USA

Please read this information carefully. You and ECMI will receive a copy of the form via email.

If you have any questions, do not hesitate to contact us.

Contact Person: Keith Cowan
Email: keith.cowan@ecmi.org
Phone: (602) 818-3606

Donation Address:
European Christian Mission International-USA
P.O. Box 563
Wheaton, IL 60187

1. Provide your broker with the following information:

ECMI-USA's broker: Edward Jones
ECMI-USA's DTC Number: 0057
ECMI-USA's Account Name: European Christian Mission
ECMI-USA's Account Number: 4480812017
ECMI-USA's Federal Tax ID number: 25-1348287
Name of stock to be transferred:
Number of shares to be transferred:

2. Please complete and submit the Stock Transfer Form below.

Securities Transfer Form

Instructions

Complete the form and submit it.
You will receive a copy at your email address listed below. Print a copy for your own records.
Contact your broker and provide him or her with a copy of the set of instructions and form.

Bolded items with an asterisk (*) are required fields.

First name*

Last Name*

Address*

StreetNumberAddition

ZIP codeTown

Country

E-mail*

Home Phone*

Your Broker/Stock Information

Brokerage/Financial Institution Name*

Broker/Contact Name*

Broker/Contact Phone*

Broker/Contact Fax

Anticipated Transfer Date*

Stock Name*

Number of Shares*

Special Instructions to Your Broker

Gift Preference Information

I would like to preference my gift to the following

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