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Certicate information
For value received, the undersigned does hereby sell, assign, or transfer the stocks or bonds described below to:
Vanguard Brokerage Services
Account number: 76580331
Name of issuer
Number of shares or bonds Type
CUSIP number
Certicate number(s)
Irrevocable stock or
bond power
Vanguard Charitable received certicates that are either unsigned or
incorrectly endorsed. Use this form to authorize Vanguard Charitable to
deposit your shares.
If you require extra space, include additional sheets. Please do not staple.
For more information, refer to our Policies and guidelines booklet.
Contact us with questions
Required signatures
The undersigned does hereby irrevocably constitute and appoint Vanguard Brokerage Services attorney to transfer
the said stocks or bonds on the books of said company, with full power of substitution in the premises. Vanguard
Brokerage Services will not be responsible for providing the donor at any time with information concerning cash/stock
dividends, stock splits, corporate actions, or any other information, advice, guidance, or recommendation with respect
to a donor order to transfer securities.
The owners named on this form must correspond in every way with the names as written on the face of the stock
certicate or bond.
If a name on the certicate is misspelled, sign this form twice: Once with the correct spelling and once with the
spelling that appears on the certicate.
If a name has changed, the appropriate endorsement is “Jane Smith now Jane Jones.”
The appropriate endorsement for a corporate ofcer is “John Doe, (title).” Example: John Doe, partner.
If no trustee names are listed on the certicate, all trustees must sign.
Provide required signatures on the following page.
ISBP 102018
Clear all
2 of 2
ISBP 102018
© 2018 Vanguard Charitable Endowment Program. All rights reserved.
Owner A
Name rst, middle initial, last
Date mm-dd-yyyy
Owner B
Name if applicable rst, middle initial, last
Date mm-dd-yyyy
Do not sign unless you
are in the presence of
the authorizing ofcer.
Return information
Return this form to Vanguard Charitable by mail.
Original documents are required.
Mail: Vanguard Charitable
P.O. Box 9509
Warwick, RI 02889-9509
Registered, certied 2670 Warwick Avenue
or overnight mail: Warwick, RI 02889-9509
A notary public cannot
provide a Medallion
signature guarantee.
Medallion signature guarantee
A Medallion signature guarantee is required. All registered owners of the certicates must be present for the Medallion
signature guarantee.
Ensure with your bank or broker that the Medallion signature guarantee(s) provided will cover the amount of the gift.
Signature of authorized ofcer Place stamp here
Medallion required
Authorized ofcers title
Name of institution
Date mm-dd-yyyy
This applies to all signatures in Section 2.