GIFT TRANSMITTAL

Return form and appropriate paperwork to Gift Processing Box #402

Gift:

Pledge:

Pledge Payment:

(pledge payment schedule required)

Purpose/Description:

Donor ID #:

Donor Name/Company/Organization:

Contact name for Company/Organization:

Address:

Dual Empl/Org ID #:

Dual Credit Name:

Amount:

$

IRS Benefit*:

$

(non-tax deductible portion)

Fund/Org #:

and/or

Designation #:

Designation List

Credit Card type (circle one):

Visa

Master Card

Discover

Diner's Club

Credit Card

Exp. Date:

CCV Code

(Last 3 digits on back of credit card)

Anonymous:

Matching Gift:

MEMORIALS and HONORARIUMS

In Memory / Honor of:

(circle one)

Notification:

(name and address)

*  Explanation:  Did the donor receive anything of value for their donation as defined by IRS guidelines?

If so, the market value needs to be indicated.

Sender Name:

Date:

School/Dept:

Phone #:

If you have questions please contact the Gift Administration Help Desk, Ext. 8-3739.

**Please DO NOT fold or staple checks.  Attach all documentation including envelopes.**