Securities Donation Transfer Intent Form

: Category: Uncategorised

To assist Chalice in processing your donation in a timely manner, please fill out and submit this form online, or email it to us prior to transferring securities.

Chalice (Canada)
101-26 Union Street
Bedford, NS B4A 2B5
Attn: Peter Gordon, Annual Giving Officer
Toll Free: 1-800-776-6855, ext 803
email: petergordon@chalice.ca

Donor Information - Name of Owner of Securities for charitable receipting purposes:

Transfer Intent Form

Name(*)

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Address

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Email(*)

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DOB

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You will receive verbal or email confirmation when your donation is received in our office and a Gift-in-Kind charitable tax receipt through the mail recognizing the value of your donation in February of the calendar year following the year of donation.

*Please be advised that the value of the donation receipt will be based on the closing price of the securities on the day that they are received into our account in accordance with Canada Revenue Agency (CRA) regulations.

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