LANE COMMUNITY COLLEGE & LCC FOUNDATION
Deposit Transmittal for College or Foundation Funds
Use this form to submit cash and check deposits to LCC or LCC Foundation. Deposits applying the rent split formula or those going to the LCC Foundation
MUST use this form. Please deliver CASH and CHECKS, along with this form, in person to College Finance. In-Kind donations must be submitted to the
Foundation using the Foundation Gift-In-Kind Form. Submitting MULTIPLE checks or cash items: For the same designation (Fund or FOAP), attach all
related correspondence. DO NOT staple or tape items to this form. Use a separate form for each different designation (Fund or FOAP).
FINANCIAL DETAIL
CHECK TOTAL: $ ____________________ CASH TOTAL: $ ____________________ GRAND TOTAL: $ ____________________
COLLEGE FUNDS: $ ____________________ ACCOUNT #: _____________________________________________________
(FOAP: XXXXXX-XXXXXX-XXXXXX-XXXXXX)
If Rental Revenue: Amount will be split 50% to dept revenue; 25% facilities maintenance & replacement; 25% General Fund overhead.
Does the deposit qualify for Rental Revenue split? YES NO
LCC FOUNDATION FUNDS: $ ____________________ ACCOUNT/PROJECT #: ________________________ (4-DIGITS: XXXX)
JUSTIFICATION DETAIL
Were goods and/or services received in relation to these funds? YES NO
If YES, please describe the good and/or services and the value of each:
____________________________________________________________________________________________________________
Were these funds generated through sales? YES NO
If YES, please describe the sale activity:
____________________________________________________________________________________________________________
Were these funds generated through fundraising or special event? YES NO
If YES, please list the event name and description of event:
____________________________________________________________________________________________________________
SPLIT GIFTS
If the revenue generated is a combination of gift and non-gift revenue, please annotate how much each is included in this deposit.
GIFT TOTAL: $ ____________________ NON-GIFT TOTAL: $ ____________________ DEPOSIT TOTAL: $ ____________________
I certify that these funds should be deposited in the: LCC FOAP listed above ______ Foundation Fund listed above ______
Any restriction on gifts will be adhered to and properly accounted for. All relevant information pertaining to the nature of this deposit has been
disclosed and any supporting documentation or correspondence has been attached.
DEPARTMENT APPROVAL REQUIRED
Department Designee: _______________________________________________________ Date: _______________________
(Printed Name) (Signature)
Department Name: _______________________________________________________ Phone: ________________________
SIGNATURES REQUIRED FOR FOUNDATION REQUESTS
Executive Dean: _______________________________________________________ Date: _______________________
(Printed Name) (Signature)
College Finance Designee: _______________________________________________________ Date: _______________________
(Printed Name) (Signature)
Who is completing this form:____________________________________ Phone: __________________________
