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Stock Transfer Intention Form

It's simple to make a gift of stock to the Roper St. Francis Foundation!

We will receive basic information about your intentions, so we can lend any assistance and credit your gift when it arrives.


  1. Fill this form out and we will contact you.
  2. Make sure you contact your broker to initiate the actual transfer.


  • Our office can help you walk through the possibilities for gift designations.
  • For security reasons, we do not ask for your account number over the Internet.

Bolded items with an asterisk (*) are required fields.

Donor Information

Address 1*
Address 2
Postal Code
Home Phone*

Broker/Stock Information

Brokerage/Financial Institution Name*
Broker/Contact Name*
Broker/Contact Phone*
Broker/Contact E-mail
Broker/Contact Fax
Anticipated Transfer Date*
Stock Name*
Number of Shares*

Special Instructions to Broker

Gift Designation Information

I would like to designate my gift to the following:



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Roper St. Francis Foundation
125 Doughty Street, Suite 790
Charleston, SC 29403

Phone: (843) 720-1205

Your support matters, donate now.

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