Letter of Instruction
Shareowner Services
PO Box 64874
Saint Paul MN 55164-0874
1. Account number or Social Security/Tax ID number
2. Company name/ issue of stock
3. Name(s) and address as registered on the account
4. Alternate address (complete only if you want the request mailed to a different address than listed above)
Write in your request:
Signature of a registered owner:
If you are signing on behalf of a registered owner, include your title after your name and review the next page for required documents to
be mailed with your request. Example: John Smith Executor, or Jane Doe Power of Attorney.
Mail your completed Letter of Instruction to:
Shareowner Services
ATTN: Imaging Services
PO Box 64874
Saint Paul MN 55164-0874
If using a courier, mail to:
Shareowner Services
ATTN: Imaging Services
1110 Centre Pointe Curve Suite 101
Mendota Heights MN 55120
Please note: If the names on the account need to be changed, a transfer is required. See Changing the
account registrationon the next page for more details.
Dom LOI Ver 3
SOnL 12/18
Instructions for individuals signing on behalf of a shareowner
If you are the: You need to include:
Executor or administrator
A copy of the court certified document dated within 60 days (within six months if
issued in New York or within one year if issued in Connecticut).
If the estate is not being probated, include a small estate affidavit and a photocopy of
the death certificate.
Your name has changed
If your name has changed, please sign the letter as your name appears on the
account, and then sign again using your new name. For example: Jane Doe now
known as Jane Smith.
Minor who is now over
the age of majority on a
Custodial account
Sign the letter and include one of the following: a photocopy of your birth certificate,
driver's license, passport, or military ID.
Power of attorney (POA)
A copy of POA document with the following statement written on the document: "The
Power of Attorney is in full force and effect, is a true and correct copy of the original,
and the maker is still alive." The POA document must state the attorney in fact can act
on behalf of share or security transactions.
Guardian or conservator
A photocopy of the court certified Letters of Guardianship/Conservatorship, dated
within the past 60 days (within six months if issued in New York or within one year if
issued in Connecticut). The Letters must authorize the Guardian/Conservator to act on
behalf of the individual’s assets.
Successor trustee
Include a Certificate of Fiduciary Authority. You may download this form at
shareowneronline.com. Under Download Forms, select “Certificate of Fiduciary
Authority.
Partnership
Chief executive partners, general partners, or managing general partners may sign
the letter listing their title, with no further documents needed. If the partnership has a
governing resolution, please follow the requirements for a corporation.
Sole proprietor
Sole Proprietors may sign the letter listing their title as Sole Proprietor or Sole Owner,
with no further documents needed.
Corporation
Investment club
School
Government agency
Religious organization
Non-profit
Financial institution
acting as custodian or
trustee
Authorized individuals may sign with their title listed after their name. You will also
need to include a copy of the corporate resolution, or governing document listing the
authorized individuals who may sign on behalf of the Company or Organization. The
resolution/document must be dated within the past 6 months. It must also contain a
corporate seal, or have a written statement on it advising there is no seal. The person
signing the resolution or document may not be the same person signing this letter.
Changing the account registration
Your name or the names
on the account have
changed
To change the names on the account, a transfer must be completed. You can
download instructions and forms at shareowneronline.com. Under Download
Forms, select “Stock Power and Transfer Instructions.”