Date

Broker Name
Address
City, State/Province   Zip/Postal Code

Dear ________________,

The purpose of this letter is to instruct you to transfer ___________ shares of (Stock Name, Common/Preferred ) from my/our account # __________________.

This transfer constitutes a charitable gift to Mercy For Animals, federal tax identification number 54-2076145.  Please transfer these shares as soon as possible to TD Ameritrade Account #784-674134, DTC #0188.  

In case you require it, Mercy For Animals’ contact information is as follows:

Mercy For Animals 
8033 Sunset Blvd., Ste. 864 Los Angeles, CA 90046
(866) 632-6446
Donations@MercyForAnimals.org

Thank you for your assistance.  I look forward to your written confirmation of the completion of this transfer.

Sincerely,

(signature)					(signature)

Donor Name   					Joint Donor Name (if applicable)
Address
City, State/Province  Zip/Postal Code