Shareholder Forms


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Form Type
   
Transfer Instruction Letter

Transfer Instruction Letter
This form should be used when submitting a certificate for transfer. It includes a Stock Power (Section C), Substitute W-9 Form (Section D), and Cost Basis Form (Section E).

   
144 Sellers Rep Letter

144 Sellers Rep Letter
This form is required to remove a restriction from a certificate that has been held 1+ years by a non-affiliate and a non-shell company.

   
Gift Letter

Gift Letter
This form is used when gifting stock certificate(s) to an individual or entity. Must also be accompanied by the Transfer Instruction Letter.

   
Stock Power

Stock Power
This form is used to authorize the change of ownership of a security. Please include the certificate number, number of shares, security name, signature and medallion. We cannot accept blank stock powers.

   
Affidavit of Domicile

Affidavit of Domicile
An affidavit of domicile is used to state where a person resides (or where a deceased person resided). This form is typically required when transferring shares of deceased owners. The signature on the form must be notarized. Must also be accompanied by the Transfer Instruction Letter.

   
Change of Address Form

Change of Address Form
Complete this form and send via fax or mail to change your address in our records.

   
One and the Same Form

One and the Same Form
Complete this form if transferring a certificate where your name was misspelled or legally changed.

   
Partnership Agreement

Partnership Agreement
This form should be used to authorize a partner (usually general partner) to transfer securities on behalf of the partnership. Must also be accompanied by the Transfer Instruction Letter.

   
LLC Certification

LLC Certification
An LLC Certification is used to authorize a managing member to transfer securities on behalf of an LLC. Must also be accompanied by the Transfer Instruction Letter.

   
Corporate Resolution

Corporate Resolution
A corporate resolution is used to authorize a corporate officer to transfer securities on behalf of the corporation. Must also be accompanied by the Transfer Instruction Letter.

   
Lost Securities Form Letter

Lost Securities Form Letter
This form is used to initiate the replacement process for a lost certificate. Please fill out the form completely.

   
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