Fidelity Charitable Irrevocable Contribution Form and Letter of Instruction Completed Form Examples and Samples
Explore real-world examples of the Fidelity Charitable Irrevocable Contribution Form and Letter of Instruction, including sample filled forms for appreciated stock donations, mutual fund transfers, and more. Learn how to correctly complete each field, understand DTC transfer instructions, and maximize your charitable tax deduction with a Fidelity Charitable Donor-Advised Fund (DAF).
Fidelity Charitable Irrevocable Contribution Form and Letter of Instruction Example – Appreciated Stock Donation
How this form was filled:
This example shows how a donor contributes appreciated publicly traded stock (Apple Inc. – AAPL) to a Fidelity Charitable Giving Account (Donor-Advised Fund). The form is completed with the donor's account details, the delivering brokerage information, the stock ticker and share count, and the irrevocable contribution acknowledgment. A Letter of Instruction is also included to direct the delivering broker to transfer the shares to Fidelity Charitable's DTC account.
Information used to fill out the document:
- Donor Full Name: Margaret L. Thornton
- Fidelity Charitable Giving Account Number: 7823-4491
- Donor Address: 482 Oakridge Boulevard, Austin, TX 78701
- Donor Phone Number: (512) 555-0192
- Donor Email Address: [email protected]
- Delivering Broker / Financial Institution: Merrill Lynch
- Delivering Broker DTC Number: 8862
- Donor's Brokerage Account Number at Merrill Lynch: 865-23741-X
- Security Name: Apple Inc.
- Ticker Symbol: AAPL
- Number of Shares to Transfer: 150
- Estimated Fair Market Value at Time of Contribution: $31,500.00
- Date Shares Originally Acquired (Holding Period): March 14, 2019
- Type of Contribution: Publicly Traded Securities (Appreciated Stock)
- Fidelity Charitable DTC Number: 0226
- Fidelity Charitable Account for Further Credit: Fidelity Charitable Gift Fund – Account 7823-4491
- Intended Grant Recipient (Advisory Preference): Austin Community Food Bank, Austin, TX
- Donor Signature: Margaret L. Thornton
- Date of Signature: February 3, 2026
- Letter of Instruction – Authorized By: Margaret L. Thornton
- Letter of Instruction – Date: February 3, 2026
- Letter of Instruction – Addressed To: Merrill Lynch, Attention: Transfer Department
What this filled form sample shows:
- Correctly completed Fidelity Charitable Giving Account number linking the contribution to the donor's DAF
- Full security details including ticker symbol (AAPL), share count (150 shares), and estimated fair market value ($31,500)
- Accurate delivering broker DTC number (8862 for Merrill Lynch) required for electronic share transfer
- Proper holding period documentation confirming long-term capital gains status (acquired March 2019) for maximum tax benefit
- Signed and dated irrevocable contribution acknowledgment confirming the donor relinquishes all control over contributed assets
- Accompanying Letter of Instruction authorizing Merrill Lynch to transfer shares to Fidelity Charitable's DTC account (0226)
- Advisory grant recommendation noted for Austin Community Food Bank, demonstrating DAF grant suggestion workflow
- Demonstrates the tax-efficient strategy of donating appreciated stock to avoid capital gains tax while claiming a fair market value deduction
Form specifications and details:
| Use Case: | Donation of appreciated publicly traded stock (long-term) to a Fidelity Charitable Donor-Advised Fund |
| Contribution Type: | Publicly Traded Securities – Appreciated Stock |
| Transfer Method: | DTC Electronic Transfer (broker-to-broker) |
| Tax Benefit Strategy: | Avoid capital gains tax on $31,500 appreciated stock; claim full FMV charitable deduction |
| Holding Period: | Long-term (over 7 years – acquired March 2019) |
| Form Components: | Irrevocable Contribution Form + Letter of Instruction |
| Delivering Institution: | Merrill Lynch (DTC #8862) |
| Receiving Institution: | Fidelity Charitable Gift Fund (DTC #0226) |
| Donor Account Type: | Donor-Advised Fund (Giving Account) |
| Grant Advisory Preference: | Austin Community Food Bank, Austin, TX |
Created: February 25, 2026 06:10 AM
