Following your verbal instructions to your broker for an electronic transfer of securities, we encourage you to send a follow-up letter of instruction (sample copy below) and to forward a copy to the Inova Health System Foundation office. For a gift of stock certificates you hold, send unsigned certificates with a similar letter to the Inova Health System Foundation, instructing us as to your wishes. Send signed stock power in a separate envelope.
Date
Broker Name AddressCity/State/Zip
Dear_________________:
This letter is to inform you of my intention to make an irrevocable gift to the Inova Health System Foundation. Please transfer ________ shares of ________________ stock to the Inova Health System Foundation which will benefit the _______________ (indicate hospital, program or facility).
The information necessary to complete this transfer is as follows:
DTC Number: 0997Customer/Fund Name: Inova Health System FoundationCustomer Account number: 06D6ABA#: 011-000-028Bank: State Street Financial CenterAttn: Kelley CondonState Street Bank & Trust Company2 Avenue de Lafayette, LCC2Boston, MA 02111-2900 Phone: 617-664-9812Fax: 617-769-6644 Please do not begin the stock transfer procedure until you contact the Foundation’s development office or accounting office. They will instruct State Street Bank and Trust Company to expect and accept the stock transfer.
Please immediately call:Patricia Bowen, Development Specialist,Inova Health System Foundation: 703-289-2056
or
Seema Khan, Senior AccountantCorporate Finance at: 703-289-2429
I will forward a copy of this letter to the Inova Health System Foundation so they too can be informed of the timing of this gift. This gift must be completed by __________ (date).
Thank you.
Sincerely, (your name)
cc: Linda RobertsonSenior Dir, Development ServicesInova Health System Foundation8110 Gatehouse Road, Suite 200 EastFalls Church, VA 22042703-289-2097 tel.703-289-2073 fax