Stock Transfer Form

Thank you for your interest in making a contribution in the form of a Stock Transfer. Please note that you must initiate all securities donations with your broker and consult your broker to ensure that the stock is eligible for electronic delivery over the Deposit Trust Company (DTC) system. This is the fastest, most secure and cost effective method of donating securities. 100% of your donation supports our fellowship program.

Acknowledgment will be made in compliance with IRS regulations. Consult your tax advisor before making a charitable donation to any organization. Donation is made to: Life Sciences Research Foundation (EIN #52-1231801)

Specific Processing Procedures

Receiving Firm Name and Address:

Morgan Stanley
attn: Joseph Cirelli
650 South Exeter Street, Suite 1100
Baltimore, MD 21202

410-736-5427
joseph.c.cirelli@morganstanley.com

DTC Eligible Securities: Deliver to DTC Clearing Number 0015
Credit to Account 633-116173-273

Please complete the information below to notify us and help ensure that your gift is processed accurately.

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Donor Name (Individual, Corporation, Foundation)

Donor Email

Donor Address

Address Line 1

Address Line 2

City

State

Zip Code

Broker Name

Broker Address

Address Line 1

Address Line 2

City

State

Zip Code

Broker Phone

Broker Email

Name & Type of Securities (e.g., DELL common stock)

Security Symbol

Number of Shares

Date of Transfer

Notes/Comments Regarding the Gift

If this contribution is being made in honor of or in memory of another person, please list their name and mailing address below (if applicable) so we may send an acknowledgment of your gift to the appropriate individual(s).

In Memory of
In Honor of

Name of Deceased or Honoree

Acknowledge with a card to

Include name and address

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