Give Stocks & Assets

Broker Shares or

Donor Name *

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Last

Primary Contact Name (if different) *

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Last

Donor Mailing Address *

Address Line 1

Address Line 2

City

State

Zip Code

Donor Phone *

Donor Email *

Type of Asset *

Asset Name / Description *

Ticker Symbol or Identifying Information

Number of Shares or Units to be Given *

Estimated Fair Market Value (if known)

Broker or Advisor Name

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Last

Broker or Advisor Phone

Broker or Advisor Email

Anticipated Transfer Date *

Special Instructions or Notes

Acknowledgment *

I would like my gift to be acknowledged publicly (name only)
I prefer my gift to remain anonymous

I understand that Christian Embassy International Church cannot provide legal or tax advice and encourage me to consult with my personal financial or tax advisor regarding this gift.

Signature *

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Printed Name *

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Date *