Stop Release Letter SRL

Account Number

Instructions: Use the Stop Release Letter when depositing an original certificate that was previously reported to the transfer agent as lost and/or stolen.
When a physical certificate is reported as lost and/or stolen, the transfer agent places a hold on the certificate, called a “stop” or “stop transfer”. To remove
this hold on the certificate, the transfer agent requires a letter signed by the certificate holder(s) in which they acknowledge the listed certificate(s) has/have
been found and authorize the transfer agent to remove the “stop” on the certificate(s).
Please mail the completed form to LPL Financial, Attn: Trade Direct, P.O. Box 509049 San Diego, CA 92150-9049 or fax the completed form to the Custody
Department at (858) 202-8500.

1. Account Information
Account Registration Social Security/Tax ID Number

2. Stop Transfer Information

To Whom It May Concern:

Please accept this letter as your authorization to release the “stop transfer” on
(number of shares)

shares of
(name of security)

Certificate number(s):

in the name(s) of
(certificate registration)

Regards,

Certificate Holder Signature Certificate Holder Name (print) Date

Joint Certificate Holder Signature Joint Certificate Holder Name (print) Date

F107-CTD
Revised 0916
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