RBC Direct Investing Inc.
Donation of Securities to a Charitable Organisation:
____________________________________________________________________________________
RBC Direct Investing
TM
account number: ___________________________________________________
Account holder’s name: _________________________________________________________________
I, _______________________________________ would like to donate the following securities:
Qty / units /face value* Description of securities to be donated:
__________________ __________________________________________________________
__________________ __________________________________________________________
__________________ __________________________________________________________
__________________ __________________________________________________________
*Quantity must be exact number of securities (units in the case of Mutual funds). If this request is completed with dollar
figures, RBC Direct Investing will not be able to process it.
Deliver securities to the charitable organisation below:
Name of charitable organisation: _____MAGEN DAVID ADOM CANADA___________________________
Attention: ________________Sidney Benizri_____________(514)731-4400_______________________
Brokerage house carrying the organisation’s account: _____ROYAL BANK PLAZA___________________
Organization’s brokerage account number: ____68924190____________________________________
Adress of brokerage: _____200 Bay St. North Tower PO BOX 75, Toronto M5J 2Z5________________
CUID code of receiving broker: DOMA DTC code of receiving broker: 5002
I hereby request to transfer assets listed to the above charitable organisation. RBC Direct investing
agrees to waive the transfer out fee for donations of securities made to a charitable organization.
Account holder’s signature: DATE: ____________________
Due to market fluctuation, the value of the donated securities can change prior to or upon receipt of securities. Clients should
therefore notify the Charitable Organisation of their intention to donate securities to their brokerage account and instruct their
broker to accept the securities without delay.
RBC Direct Investing Inc. and Royal Bank of Canada are separate corporate entities which are affiliated. RBC Direct Investing Inc.
does not provide investment advice or recommendations regarding the purchase or sale of any securities. Investors are responsible
for their own investment decisions. RBC Direct Investing is a business name used by RBC Direct Investing Inc.
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Bank of Canada. ®Registered trademark of Royal Bank of Canada. RBC and Royal Bank are registered trademarks of Royal Bank of
Canada. Used under licence. ©Royal Bank of Canada 2010. All rights reserved.
Account Holders name
E-FORM 22143 (08/2010)
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