Letter of Authorization

Letter of Authorization from Donor to Broker for Transfer of Securities for Charitable Purposes to Meagan Bebenek Foundation.

Authorization Letter

Donor Information

The below name will be noted on the tax receipt, if different, please advise

First name

Last name

Phone

Mailing Address

Street Address

City

Region/State/Province

Street Address Line 2

Postal / Zip code

Description of Mutual Funds, Stocks, etc.

This letter will confirm my intention to donate the following to Meagan Bebenek Foundation

Security Name

Quantity

CUSIP/ISIN

Security Name

Quantity

CUSIP/ISIN

Security Name

Quantity

CUSIP/ISIN

Broker/Delivering Custodian Information (if applicable)

Name of Firm

Name of Broker

Broker Telephone #

Broker Email

All donated securities are sold upon receipt. The value of the donation will be based on the closing price of the security on the day that it is received by Meagan Bebenek Foundation.

Donor Authorization

I authorize Meagan Bebenek Foundation or its agent to contact my broker for purposes of concluding this transaction. Unless otherwise noted, I/we agree that the gift is unrestricted and shall be used at the discretion of the Meagan Bebenek Foundation.

Signature

Name

Signature

Name

Transfer To

Edward Jones, 90 Burnhamthorpe Rd. W., Suite 602, Mississauga, ON L5B3C3

Contact: Samantha Bodger, FA

Phone: 905-722-9218 Fax: 1-888-836-4609

Please note that Meagan Bebenek Foundation is unable to issue income tax receipt until we are aware of your donation. To ensure prompt and accurate receipting of your donation prior to transferring any securities to the Meagan Bebenek Foundation Account, please submit this form.

Successfully submitted authorization letter.