ShareGift Donation CouponShareGift Donation Coupon
This coupon is not a stock transfer form. ShareGift will send you the correct form to sign.
| Name: | __________________________________________________ |
| Address: | __________________________________________________ |
| __________________________________________________ | |
| __________________________________________________ | |
| __________________________________________________ | |
| Post Code: | __________________________________________________ |
| Contact Telephone: | __________________________________________________ |
Please ensure that we have your current address - even if this differs from the address on your share certificate(s).
I would like to donate these shares through ShareGift - please send me the appropriate forms for the transfer.
| Name of Company 1: | __________________________________________________ |
| Number of Shares: | __________ |
| Name of Company 2: | __________________________________________________ |
| Number of Shares: | __________ |
| Name of Company 3: | __________________________________________________ |
| Number of Shares: | __________ |
| Name of Company 4: | __________________________________________________ |
| Number of Shares: | __________ |
Signature _____________________________ Date ________________
Please attach your share certificate(s) to this coupon, and send to:
ShareGift,
46 Grosvenor Street,
London,
W1K 3HN