Legal Transfer Form
Broadridge Corporate Issuer Solutions
P.O. Box 1342
Brentwood, NY 11717-0718
Phone: (877) 830-4936
Thank you for contacting Broadridge Shareholder Services regarding a transfer. Enclosed is the document you requested.
Please read the content carefully and follow all of the instructions provided.
Things to remember before sending in your completed form:
1. Make sure your form has all of the required signatures. If you are signing for the shareholder, please include your
title (i.e., Power of Attorney, Custodian, Executor) after your signature. Your Legal Transfer will require a Medallion
Signature Guarantee (MSG). Sign the form in the presence of the individual who will provide the Guarantee
(usually your banker or broker).
2. You must include all stock certificates with the completed transfer paperwork. If you do not have all of your
certificates, please contact us and we will send you the paperwork required to replace the certificates and