Fillable Form 1: Irrevocable Stock or Bond Power (American Red Cross)

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Form 1: Irrevocable Stock or Bond Power (American Red Cross)

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The Form 1: Irrevocable Stock or Bond Power (American Red Cross) form is 1 page long and contains:

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Country of origin: US
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Account Number
–
Irrevocable Stock or Bond Power
To allow Fidelity Brokerage Services LLC to facilitate the processing of your certificate(s) in the absence of your endorsement on the certificate(s), please
complete and sign this stock/bond power, which we will then attach to the certificate(s). Return this form to your Broker/Dealer.
Registration
Primary Account Holder Name
Entity/Business/Trust Name
Social Security Number or Taxpayer ID Number
Joint Account Holder/Trustee Name (If Any)
Social Security Number or Taxpayer ID Number
Irrevocable Stock or Bond Power for Value Received
The undersigned does (do)
hereby sell, assign and transfer to (name of person or entity who will receive the securities)
2
1
If stock, complete this portion
(Number of Shares)
Shares of the
(Common/Preferred)
Stock of
Represented by Certificate(s) Number(s):
Certificate Number
Certificate Number
Inclusive, standing in the name of the undersigned on the Books of said
Company.
If bonds, complete this portion
(Number of Bonds)
Bonds of the
(Description of the Company or Municipality)
in the principal amount of $ (face value)
Represented by Certificate(s) Number(s):
Certificate Number
Certificate Number
Inclusive, standing in the name of the undersigned on the Books of said
Company.
The undersigned does (do) hereby irrevocably constitute and appoint National Financial Services LLC, attorney to transfer the said stock or bond(s) as the
case may be, on the books of said Company, with full power of substitution in the premises.
Signature
Note: If the stock is registered in more than one name, please have all parties sign below exactly as their name(s) appear on the certificate(s).
3
1. Signature Date
2. Signature Date
3. Signature Date
4. Signature Date
5. Signature Date
6. Signature Date
National Financial Services LLC, Member NYSE, SIPC 1.809719.100 – 390850 (12/04)
Medallion Medallion
Medallion
Signature Guarantee
Medallion
Signature Guarantee
1.809719.100 009920001
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Form 1: Irrevocable Stock or Bond Power (American Red Cross)

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Completed 4 May 2021

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