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Name
____________________
Address ____________________
Date ____________________
Broker/Banker Name ____________________
Company Name ____________________
Address ____________________
Re: [Your account number]
To
whom it may concern:
I
would like to make a donation of
[number] shares
of [name of
common stock] common
stock from my account number
________________. Please transfer these
shares to Amphibian Conservation Alliance
(for use in
[specific chapter, program or
project] if
any).
You
may contact Paul Speck, President, at (703)
807-5588, ext. 600 to arrange the transfer. Amphibian
Conservation Alliance's tax identification
number is 94-3267302.
The
address is:
Amphibian Conservation Alliance
Attn: Paul Speck, President
1700 N. Moore Street, Suite 2000
Arlington, VA 22209
My signature is guaranteed on this letter.
(Signature)
Donor(s)
cc:
Amphibian Conservation Alliance
Attn: Paul Speck, President
1700 N. Moore Street, Suite 2000
Arlington, VA 22209
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