Date: _____________________________
RE: Donor's Account Number: _________________________________
Registration on Account: __________________________________
Dear ______________________________:
(Your stockbroker)
This letter transmits the following gift of securities to Fred Hutchinson Cancer Research Center:
Name of Security: _________________________ Number of Shares/Units: ________
Name of Security: _________________________ Number of Shares/Units: ________
This also directs you to remove the said securities from my (our) account referenced above and to transfer them to the Hutchinson Center account:
Account Number: 4DR-109289 at Pershing LLC
Receiving Firm Clearing Number at Pershing LLC is: DTC#0443
Contact: Bob Frey - Telephone: (206) 285-1730, Fax: (206) 284-5249
Before transferring the stock please notify Eileen Edel at Fred Hutchinson Cancer Research Center, by telephone (206) 667-5569 or (800) 279-1618 ext. 5569, fax (206) 667-5826 or e-mail (eedel@fhcrc.org).
The undersigned owner(s) making this donation, relinquishes all right, title and interest in said certificate(s) and the shares of stock or bonds represented thereby, and do hereby irrevocably release and discharge you of any claims thereto.
Sincerely,
_____________________________________
_____________________________________