CHECKLIST FOR GIFT DONORS
This packet tells you what you need to do to give a gift of shares:
□ Read the enclosed brochure which may answer questions you may
have about the share gifting process.
□ Complete the Gift of Settlement Common Stock form and sign it in front of a notary
public or postmaster.
□ Complete the Family Tree form.
□
Make sure your gift recipient fills out the Recipient Packet.
□ Submit the packet to Yak-tat Kwaan Inc. at:
Yak-tat Kwaan Inc.,
Po Box 416
Yakutat, AK 99689
Fax: 907-784-3622
Note: If you or the recipients have any questions, please call the Yak-tat Kwaan office
between the hours of 8:00am -5:00pm, Monday through Thursday, or 8:00am - 4:00pm on
Friday’s, at 907-784-3335.
YAK-TAT KWAAN, INC. * P.O. BOX 416 * YAKUTAT, ALASKA 99689*907-784-3335 or 784-3488* FAX 907-784-3622
Gift of Settlement Common Stock
I, _____________________________________________________, shareholder of
(Full name of Donor as it appears on Yak-tat Kwaan Stock)
Yak-tat Kwaan Inc. herby gift, assign, transfer, convey of the following number of my shares of
my Yak-tat Kwaan Incorporated stock and all rights, privileges and benefits related to or on
account of each stock to the following person(s):
RECIPIENT(s):
DOB:
RECIPIENT
SOCIAL SECURITY
NUMBER:
RELATIONSHIP:
NUMBER
OF
SHARES:
I understand that I cannot revoke, take back, or otherwise change this gift once it has been
made.
I understand that there may be taxes owed as a result of this transfer. Yak-tat Kwaan
Incorporated will not be held responsible for payment and that any such taxes will be either my
responsibility as donor or the recipients responsibility.
I understand that if the recipient is under the age of 18 years, there will need to be an
appointed custodian to care for these shares.
I understand that by signing this Affidavit I am swearing under oath to the best of my
knowledge and belief that everything stated herein is true and that I am acting under my own free
will and am not under any undue pressure, influence or duress.
YAK-TAT KWAAN, INC. * P.O. BOX 416 * YAKUTAT, ALASKA 99689*907-784-3335 or 784-3488* FAX 907-784-3622
I affirm that I have not received anything of value nor was I promised anything of value as
compensation or payment for the stock in which I am transferring.
DATED this
, day of
,20
, State of
, at
.
DONOR Signature X
STATE OF ALASKA
)
)ss.
JUDICIAL DISTRICT )
The foregoing instrument was acknowledged before me this
day of ______________________ , 20_____ , by ___________________________________
.
Notary Public for Alaska
My commission expires:
YAK-TAT KWAAN, INC. * P.O. BOX 416 * YAKUTAT, ALASKA 99689*907-784-3335 or 784-3488* FAX 907-784-3622
Family Tree
Great Grandfather
Grandfather
Tribal affiliation:
Tribal affiliation:
Tribal affiliation:
Tribal affiliation:
Father
Great Grandmother
siblings:
Great Grandfather
Tribal affiliation:
Tribal affiliation:
Grandmother
Tribal affiliation:
Great Grandmother
Recipient
Great Grandfather
Grandfather
Tribal affiliation:
Tribal affiliation:
Tribal affiliation:
siblings:
Great Grandmother
Mother
Great Grandfather
Tribal affiliation:
Tribal affiliation:
Tribal affiliation:
Grandmother
Tribal affiliation:
Great Grandmother
YAK-TAT KWAAN, INC. * P.O. BOX 416 * YAKUTAT, ALASKA 99689*907-784-3335 or 784-3488* FAX 907-784-3622