Fillable Donor Advised Fund Grant Recommendation Form

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Donor Advised Fund Grant Recommendation Form

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Donor Advised Fund Grant Recommendation Form
(Note: This form is only for donors with a donor advised fund held at the Community Foundation.)
Name of Fund:______________________________________________________ Date: ____________________
Grant Recommendation 1
Charity Name ____ I/We wish to remain anonymous to the grant recipient
TAX ID # of Charity
Charity mailing address
Attention
City
State
Zip
Phone
($250 minimum)
Grant purpose
____ General support ____ Special project ________________________________________________
____ Capital campaign ____ To honor the work of (name) _
___________________________________
Other instructions
Grant Recommendation 2
Charity Name ____ I/We wish to remain anonymous to the grant recipient
TAX ID # of Charity
Charity mailing address
Attention
City
State
Zip
Phone
($250 minimum)
Grant purpose
____ General support ____ Special project ________________________________________________
____ Capital campaign ____ To honor the work of (name) _
___________________________________
Other instructions
Check(s) will be mailed directly to the recipient organization(s) along with a grant transmittal letter outlining the grant details.
I/we certify that the above recommendation(s) does not represent the payment of any irrevocable/legally binding pledge/other
financial obligation, nor does the undersigned, any family member, advisor or any other related party expect any personal
benefit (such as tickets, memberships, meals) from this charitable distribution. I/we also acknowledge the above
recommendation(s) is subject to approval of the Community Foundation Board of Directors.
_____________________________________________ __________________________________________________
Signature Printed Name / (Phone or Email)
_____________________________________________ __________________________________________________
Signature Printed Name / (Phone or Email)
Mail or email completed form to:
Greater Salina Community Foundation • PO Box 2876 • Salina, KS 67402-2876 • accounting@gscf.org
or return to your local affiliate foundation office or board member
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Donor Advised Fund Grant Recommendation Form

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Completed 7 January 2022

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