Stock Transfer Information Request

Thank you for considering a stock gift to CKS!

First Name

Last Name

City

State

ZIP

Phone number

Email Address

I would like to gift the following to CKS:

# shares

Ticker symbol

My gift should be directed to:

Annual DuesUnrestricted DonationRestricted Donation

Please provide additional details about the gift direction, if necessary.

Your Brokerage Account Information

Firm Name

Account Number

Wed, December 4 2024 3 Kislev 5785