NOTICE OF STOCK/MUTUAL FUND GIFT TO 
DIOCESE OF CHARLOTTE

Mail or fax this page to: Catholic Diocese of Charlotte

Attn: Finance Office-Stock Processing
1123 South Church Street
Charlotte, NC 28203

or

Fax: (704) 370-3378

Name of individual or entity making the gift:

Address

Phone: Parish: Quantity & stock/mutual fund donated:

How donated:

Electronically: Yes or No

If no, certificate delivered to Wachovia Bank located at:

If electronically, donor's broker/agent:

Broker/Agent's telephone:

Date of gift:

Beneficiaries/restrictions:

Name of entity (or Diocese of Charlotte) # of shares Restrictions

It is very important that you complete and send or fax us this attachment so that we can distribute the proceeds according to your wishes. Thank you very much.