Donate Shares

Full registered name(s) *

NOTE - This is the name the shares are registered in. If these shares are not in your name, please state in what capacity you are acting for the shareholder in the notes section below

Additional holder name(s) (if any)

Full registered address (including postcode) *

Email address *

Confirm Email Address *

Shareholding 1

Which Company are the shares held in? *

How many shares are held? *

Shareholder reference number

Shareholding 2 (optional)

Which Company are the shares held in?

How many shares are held?

Shareholder reference number

Shareholding 3 (optional)

Which Company are the shares held in?

How many shares are held?

Shareholder reference number

Shareholding 4 (optional)

Which Company are the shares held in?

How many shares are held?

Shareholder reference number

NOTE - Also referred to as the Security Reference Number or Investor Code (IVC) depending on the registrar. This is usually an 8 or 11 digit code and should be found on most correspondence from the Company. This is not the certificate number.

Do you have valid share certificates for this shareholding? *

NOTE - If you are unsure as to whether the certificates you hold are currently valid, or if you only have some of the share certificates, please specify details of the certificates you do have in the notes section below.

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Notes

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Donations Made

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Charities Supported

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