Stock Transmittal Form

Nightingale Account Information

Please contact your bank or broker and provide them with the following account information:

BROKER 
Merrill Lynch
Attn: Thomas Moore
601 Lexington Ave, 47th Floor
New York, NY 10022

phone: 212-284-5850
fax: 646-651-4506
email: t_moore@ml.com

ACCOUNT NAME
Nightingale-Bamford

DTC NUMBER
8862

A/C (Nightingale Gift Account)
862-02156

FED ID (Nightingale Federal ID)
13-1106710

If you are making a gift of stock to the Nightingale Fund, please complete the form below.