Electronic Transfer Authorization Form

Thanks for your inquiry regarding a gift of stock to the Muscular Dystrophy Association. We’re deeply grateful for your interest in supporting the Association’s programs.

As requested, I’ve listed below the information for a transfer of securities directly to MDA’s broker:

Attn: Darrah L. Gleason
Citigroup Smith Barney
450 Lexington Avenue, 40th Floor
New York, NY 10017
(212) 692-2810
darrah.l.gleason@smithbarney.com

DTC #418
For Account #345-31350-18-794
Account Name: Muscular Dystrophy Association, Inc.
MDA's Tax ID #: 13-1665552

If you’re donating appreciated securities held long-term (at least 12 months and one day), it’s important that you don’t sell the stock but rather transfer it directly to MDA so you can avoid the capital gains tax that would otherwise be realized on the sale.

To ensure that you receive appropriate documentation of your gift for tax reporting purposes, please notify MDA via phone or e-mail the information listed below:

• Your complete name and mailing address
  
  
• Number of Shares
  
  
• Name of Stock
  
  
• Expected Transfer Date
  
  
• Approximate Value of Stock
  
  

Please call MDA's Planned Giving & Philanthropy Department at 800-223-6011 or 520-529-2000 or Philanthropy@mdausa.org if we can be of additional assistance.