| ADJUSTMENT REQUEST | |||||||||
| Return form and appropriate paperwork to Gift Processing Box #402 | |||||||||
| Gift: | Pledge: | Pledge Payment: | |||||||
| Reason for adjustment: | |||||||||
| Account Closed | Donor Request | ||||||||
| Administrative | Insufficient Funds | ||||||||
| Data Entry Error | Not a Gift | ||||||||
| Empl/Org ID #: | |||||||||
| Donor Name/Company/Organization: | |||||||||
| Gift/Pledge #: | |||||||||
| Amount: | $ | ||||||||
| Dual Empl/Org ID #: | |||||||||
| Dual Credit Name: | |||||||||
| Requested change: | |||||||||
| Requester Name: | Phone #: | ||||||||
| School/Dept: | |||||||||
| If you have questions please contact Donna Watson, Ext. 82873. | |||||||||
| **Please include any documentation that supports this request.** | |||||||||