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Letter of Authorization to Broker Duplicate
Date
MM slash DD slash YYYY
Broker's Name
First
Last
Company
Address
Street Address
City
State / Province / Region
ZIP / Postal Code
Dear
Name
(Required)
Please accept this form as your authorization to transfer irrevocably the following securities out of my account #
Account Number
(Required)
as a gift to Public Radio For The Front Range (KRFC 88.9 FM):
Name of security/securities:
Name of security
(Required)
Number of shares:
Number of shares
KRFC 88.9 FM prefers that the securities be electronically transferred to its account at:
Morgan Stanley
Attn: Joyce Moreno 6125 Sky Pond Drive
Suite 100
Loveland CO 80538 970-776-5520
DTC #0015 Acct# 687-023132-092
This gift is for the benefit of the following department, program, fund, or project (allocation instructions):
To ensure this gift is properly allocated, please send gift details, including donor name(s), name of security, number of shares, and allocation instructions to donations@krfcfm.org and include this information on the transaction memo line.
Sincerely,
Signature
Signature
Printed Name
Printed Name