CORPORATE DONOR ADVISED FUND GIFT INSTRUMENT Section One – Organizational Donor Organization’s Name: _____________________________________________________________________________ Mailing Address: _________________________________________________________________________________ City: ___________________ State: _______________ Zip: ____________ Phone Number: ___________________ PRIMARY CONTACT (Authorized Representative of the Organization) Contact: _______________________________________ Title: _____________________________________ Phone Number: _________________________________ Email: ___________________________________ The fund advisors is/are as follows: ADVISOR 1/CHAIRPERSON
ADVISOR 2
(This advisor will serve as chair for this fund)
Name: ________________________________________
Name: ________________________________________
Title: _________________________________________
Title: _________________________________________
Mailing Address: ________________________________
Mailing Address: ________________________________
City: ____________________ State: ____ Zip: ________
City: ____________________ State: ____ Zip: ________
Business Phone (direct): __________________________
Business Phone (direct):__________________________
Email: ________________________________________
Email: ________________________________________
Section Two – Fund Name & Anonymity The name of the Fund shall be: _______________________________________________________________________ Every grant made from a fund at the Foundation is coupled with a letter identifying the name of the fund and the name of the donor(s) recommending the grant, unless you request anonymity. Organizational donor(s) and fund names are often listed in our written and electronic publications as well. ○ The organization would like to remain anonymous. ○ The organization would like grants from the above fund to remain anonymous. ○ The organization would like the above fund listed as anonymous in the Foundation’s publications. Section Three – Fund Purpose The Fund shall be held for general charitable purposes and shall be (choose one): ____ Initial(s)
○ Endowed, meaning the organization would like the fund to be permanent and limit the amount available for grantmaking to the Foundation’s spending policy
____ Initial(s)
○ Non-Endowed, meaning the organization would like the fund to be able to make grants from the entire balance
I/We have provided a charitable “guide” for our successor advisor(s) in the attached “Statement to Successor Advisors”. Note that distributions from the Fund are subject to the Foundation’s “Terms and Conditions Applicable to Corporate Donor Advised Fund Gift Instruments”. (03-2018)