Fillable Letter of authorization (Vanguard Charitable)

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Letter of authorization (Vanguard Charitable)

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The Letter of authorization (Vanguard Charitable) form is 5 pages long and contains:

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  • 6 check-boxes
  • 85 other fields

Country of origin: US
File type: PDF

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Transfer of ownership instructions
To the transfer agent or broker: Your client is authorizing the transfer of ownership of the following assets to Vanguard
Charitable. Securities should be transferred in-kind and should not be liquidated.
Vanguard mutual fund held at The Vanguard Group, Inc. (Vanguard) and/or
Vanguard Brokerage Services (VBS)
Enter account registration and complete Section 1a. Review section 3 if assets are more than $2
million.
Security held at Vanguard Brokerage Services (other than a Vanguard mutual fund
)
Enter account registration and complete Section 1b. Review section 3 if assets are more than $2
million.
Vanguard brokerage money market settlement fund
Enter account registration and complete Section 1c. Shares of the money market settlement fund
will be liquidated and transferred as cash from your Vanguard Brokerage Account.
Stock certificate
Complete Section 1d. A Medallion signature guarantee is required.
Mutual fund held outside Vanguard or Vanguard Brokerage Services
Enter account registration and complete Section 1e. A Medallion signature guarantee is required.
Account registration
Must match the information on file at the firm holding the assets.
Gift from account number at firm holding the assets
Name of trust/organization
Taxpayer Identification Number last 4 digits Trust agreement date mm-dd-yyyy
Name of owner/trustee/officer A salutation, first, middle initial, last
Name of owner/trustee/officer B salutation, first, middle initial, last
}
Only select one
asset type.
}
Complete if assets are
owned by a trust or
organization.
1
Letter of authorization
Use this form to authorize a firm to transfer your assets to Vanguard
Charitable. A separate Letter of authorization is required for each unique:
(1) asset type,
(2) account registration, and
(3) firm.
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
888-383-4483
donorservice@vanguardcharitable.org
VCLA 122017
Clear all
Print
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VCLA 122017
Form continues on next page
Gift to Vanguard Charitable brokerage account 76580331
Fund
name
Ticker
symbol
Number of shares
or “All”
Specific ID cost basis method only
Security/fund name Ticker symbol
Number of shares Date shares acquired Purchase price per share
Lot 1
$
Lot 2
$
Lot 3
$
Note: If you prefer to use specific identification for this transaction, but your account is using
the average cost basis method, either by your affirmative election or Vanguard’s default, you
must change your cost basis method to specific identification in writing. Contact Vanguard for
more information.
1a. Vanguard mutual fund held at Vanguard or Vanguard Brokerage Services
}
To specify lots,
complete these fields
and enter shares below.
}
To specify lots,
complete these fields
and the fields above.
For additional lots,
attach extra paper
signed at dated by all
registered owners.
These pages should
include the following:
account number, fund
name, and date shares
acquired.
Security/fund
name
Ticker
symbol
Number of
shares or “All”
Approximate
value
$
$
$
Specific ID cost basis method only
Security/fund name Ticker symbol
Number of shares Date shares acquired Purchase price per share
Lot 1
$
Lot 2
$
Lot 3
$
Note: If you prefer to use specific identification for this transaction, but your account is using
First In, First Out (FIFO) cost basis method, either by your affirmative election or Vanguard’s
default, you must change your cost basis method to specific identification in writing. Contact
Vanguard for more information.
1b. Security held at Vanguard Brokerage Services (i.e. stock, bond, ETF, non-Vanguard mutual fund)
}
To specify lots,
complete these fields
and enter shares below.
}
To specify lots,
complete these fields
and the fields above.
For additional lots,
attach extra paper
signed at dated by all
registered owners.
These pages should
include the following:
account number, fund
name, and date shares
acquired.
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VCLA 122017
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Delivering firm information
Firm name
Firm contact salutation, first, last
Preferred phone
Street address or P.O. box number
City State Zip
For internal use only
ACAT Non-ACAT Distributions in cash
1e. Mutual fund held outside Vanguard or Vanguard Brokerage Services
Gift to Vanguard Charitable brokerage account 76580331
Receiving firm clearing number: 0062
Taxpayer ID: 23-2888152
Number of
shares
Fund name CUSIP or
ticker symbol
Mutual fund
account number
}
Transfers in dollar
amounts cannot be
processed.
Gift to Vanguard Charitable brokerage account 74703205
Name of
security
Number
of shares
1d. Stock certificate
}
Reference our Make a
contribution form for
instructions on how to
properly endorse the
certificate.
}
Include with this form
an account statement
less than 90 days old
from this firm.
Dollar amount
$
1c. Vanguard brokerage money market settlement fund
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VCLA 122017
Authentication
Additional authentication is required if you are contributing assets valued at $2 million or more at Vanguard.
Authentication for these assets must be completed using one of the following:
(1) Vanguard voice verification™ or
(2) Signature guarantee, or
(3) Medallion signature guarantee.
A Medallion signature guarantee is required if you are contributing:
(1) stock certificates, or
(2) mutual fund shares held outside Vanguard
If you are using a Signature guarantee or Medallion signature guarantee, complete Section 4.
3
Required signatures
By signing below, I authorize the transfer of the securities described in Section 1 to Vanguard Charitable in accordance
with the terms of this form. I hereby irrevocably relinquish all rights, title, and interest to the assets specified in
Section 1 to Vanguard Charitable, and understand that by requesting this transfer, I will be giving up full rights,
ownership, and any and all claim to the assets. I hereby acknowledge that I have read and understand the terms of the
transfer of assets I have requested and further acknowledge that the terms of this transfer are binding regardless of
any other agreement I have with Vanguard Charitable. I confirm I have full authority to give this authorization.
If a Medallion signature guarantee is required for your contribution, do not sign unless you are in the presence of an
authorizing officer. Signature dates must match Medallion signature guarantee.
2
Owner/Trustee/Officer A
Name first, middle initial, last Social Security Number last 4 digits
Signature
X
Date mm-dd-yyyy
Owner/Trustee/Officer B
Name first, middle initial, last Social Security Number last 4 digits
Signature
X
Date mm-dd-yyyy
Form continues on next page
Check this box if you intend to use Vanguard voice verification in lieu of signature
guarantee. However, you must be enrolled in the service, which can take up to one week
to complete. For more information or to register, contact your Vanguard representative.
Name of your Vanguard representative if known
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VCLA 122017
© 2017 Vanguard Charitable Endowment Program. All rights reserved.
Return information
Return this form and required
documentation to Vanguard Charitable.
If the document has a Signature guarantee
or Medallion signature guarantee, it must
be mailed.
Email: donorservice@vanguardcharitable.org
We recommend encrypting the form and
sharing the password with us.
Fax: 866-485-9414
Mail: P.O. Box 9509
Warwick, RI 02889-9509
Registered, certified 2670 Warwick Avenue,
or overnight mail:
Warwick, RI 02889-9509
Signature guarantee
A Medallion signature guarantee is required to transfer the following assets to Vanguard Charitable:
(1) stock certificates, and/or
(2) mutual funds held at a firm other than Vanguard
All registered owners must be present for the Signature guarantee or Medallion signature guarantee. Some brokerage
firms may require one guarantee for each signature on the form. Ensure with your bank or broker that the Medallion
signature guarantee(s) provided will cover the amount of the gift.
4
}
A notary public cannot
provide a Signature
guarantee or Medallion
signature guarantee.
Signature of authorized officer Place stamp here
Authorized officer’s title
Name of institution
Date mm-dd-yyyy
This applies to all signatures in Section 2.
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Letter of authorization (Vanguard Charitable)

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Completed 24 April 2021

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