Name Change (Marriage, divorce or court order)
Name Change Due To A Marriage,
Divorce, Court Order, Or Registration Error:
- The original stock certificate(s) and/or affidavits of loss.
- Signature(s) of the registered owner(s) on the reverse side of each
certificate or stock power with a Medallion Signature Guaranteed
- A letter of instruction indicating the name, complete address, (including
zip code) and Social Security Number or Tax Identification Number of the new
registration. Execute the Substitute Form W-9, on the stock power,
certifying the Social Security or Tax Identification Number of the new
Certification of Identity form
A certification / statement verifying that you are known by two different names, yet are one in the same person. You must sign your name as both individuals and the document must be medallion guaranteed.
Note: If you are making a change due to a spelling or other error in
the registration, follow the above instructions. However, for the signature,
please sign your name exactly as it currently appears on the face of the
certificate and sign again as you would like it to appear. The signature(s) must
be Medallion Signature Guaranteed.
6201 15th Avenue
Brooklyn, NY 11219
Attn: Transfer Department