Facts for Advisers

To give a percentage of the estate:

_______ percent of my estate to be used by National Society to Prevent Blindness, DBA Prevent Blindness America, for its general purposes.

To give a residual amount or remaining interest:

the rest, residue and remainder of my estate after all debts, expenses and taxes have been paid and all the general and specific bequests have been made, to be used by National Society to Prevent Blindness, DBA Prevent Blindness America, for its general purposes.

To give a tangible asset or property:

_______ shares of common stock of __________ (or insert here a description of other property) owned by me at my death as these shares shall exist at the date of my death, to be used by National Society to Prevent Blindness, DBA Prevent Blindness America, for its general purposes.

Please call Jerome Desserich at (312) 363-6020 if you have any additional questions.

Contact Information:

National Society to Prevent Blindness
211 West Wacker Drive, Suite 1700
Chicago, IL 60606
(312) 363-6001, (800) 331-2020
Fax: (312) 363-6052

Securities Transfers

DTC Number: 2251

Account Number: Please call Prevent Blindness America for further account information.

Taxpayer ID Number: Please call Prevent Blindness America for further account information.

Our Broker: LaSalle Bank N.A.

Brokerage Office Telephone: (312) 904-1873

Brokerage Office Fax Number: (312) 904-2339

Please telephone our office if your client is transferring shares to Prevent Blindness America.
We need to know the name and numbers of shares being transferred.