Fillable University of new haven IRA Charitable Transfer Instructions

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University of new haven IRA Charitable Transfer Instructions

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The University of new haven IRA Charitable Transfer Instructions form is 2 pages long and contains:

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  • 7 check-boxes
  • 20 other fields

Country of origin: US
File type: PDF

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!
IRA!Charitable!Transfer!Instructions!
Date:!! ! ______________________"
To:"" "" " _________________________________________________________"
""""""""""""""(Firm"that"administers"my"IRA"Account)"
!
Address:! "" _________________________________________________________"
City/State/Zip" _________________________________________________________"
From:"
Name:!! ! _____________________________________
Address:! ! ________________________________________
_____________________________________
"
Phone!number: _____________________ Email:"________________________
I"am"he re b y"r eq uesting"th a t"y o u "make"a"dir ec t"q u a lifie d "c h ar ita b le "d ist rib u tion"from "my"Individual"
Retirement"Account"#"_______________________________"to"the"University"of"New"Haven"as"provided"for"
under"the"Tax"Increa se "P re v en t io n "A c t"o f"2 0 1 5 and "section"408(d)(8)"of"the"Internal"Revenue"Code"of"1986,"
as"amended."The"University"of"New"Haven’s"tax"identifica tio n "n umber"(EIN )"is "0 6 - 0761704."
"
___"Please"transfer"funds,"or"issue"a"check,"in"the"amount"of"$"________________________________,"
payable"to"the"University!of!New!Haven."
"
___"Please"transfer"the"following"securities"to"the"University"of"New"Haven"(Name"and"number"of"shares):"
______________________________________________________________________________"
For"instructions"to"wire"transfer"securities,"please"use"this"link:"
www.newhaven.edu/supportunh/gift/securities."
"
In!your!t ra n smittal!to!th e !U n iv e rs ity !o f!New!Ha v en ,!p le a se !in c lu d e!both!pages!of!this!form,!which!shows!
my!name!and!address!as!the!donor!of!record,!indicates!that!the !tran sfer!is!be ing !m ad e!fro m !m y!IRA !
account,!and!not ifie s !th e !U n iv er sit y !of !th e !p u rp o s e!o f !my!gift.!Please!c op y !m e !o n !yo u r!tra n smittal.!
"
If"you"ne e d "to "c o n tact"me,"I"can"be"reached"at"the"following"phone"number:"_______________________,"or"
the"following"em a il"addre ss:"___ __ ___ __ __ ___ __ ___ __ __ ___ __ __. "
"
Thank"you"for"your"assistance"with"this"transfer."
"
Sincerely,"
"
Printed"name:"______________________ "Signature:"____________________________________
!
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IRA!Charitable!Transfer!Instructions!(Page!2!o f!2)!
"
Donor!Instructions!to!the!University!of!New !Ha ve n!
"
I"intend "m y "g ift"t o "b e"used"for"t h e"f o llo w in g "p u r p o se :"
"
____"Unrestricted"Annual"Fund"
____"Annual"Scholarship"Fund""
____"Pledge"Payment"on"my"existing"pledge"for"_________________________________"
____"Establishing"a"Permanently"Endowed"Named"Fund"(Minimum"pledge"$20,000)""
""""""""""""Specify"Fund"Name:"________________________________________________________"
____"Other,"please"specify:"__________________________________________________"
Printed"donor"name:"______________________ Signature:"_________________________________
"
Date:"____________________________________"
"
To"wire"transfer"cash,"please"send"to:""
Account"Name:""UNH"Gift"Account"
Bank"Name:""""""""Wells"Fargo"Bank"N.A."
Bank"Address:""""205"Church"Street"
" " "New"Haven,"CT"06510"
Account"#"""""""""" "2000039431693"
RTN:"""""""""""""""""" "121000248"
Swift"ID:""""""""""" "WFBIUS6S"
Chips"UID:""""""""" "0407"
" Account"Type:""""Checking"
"
So!that!we!may!properly!credit!this!gift!by!wire!transfer!for!the!intended!purpose,!please!send!a!copy!of!
this!form!to:!Bob"Congdon,"Director"of"Gift"Planning,"at"the"address"below."
!
If!sendin g !th e !d o na t ion !b y !mail,!pleas e!e n c lose!a!copy!of!this!form!and!mail!to:!
Bob"Congdon""
Director"of"Gift"Planning""
Office"of"Advancement"
University"of"New"Haven"
300"Boston"Post"Road"
West"Haven,"CT"06516"
203-479-4295"Office"
203-931-6053"Fax"
rcongdon @ n ew h ave n.e du "
"
"
"
"
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University of new haven IRA Charitable Transfer Instructions

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Completed 21 January 2020

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