Donor Information. The Act bars stations from renting contributor names, donor names, other personally identifiable information (collectively Personal Information) to or from or exchanging Personal Information with any Federal, State, or local candidate political party, or political committee. In addition, Grantees are barred, unless required by law, from disclosing Personal Information of contributors or donors to any Nonaffiliated Third Party (these terms are defined in the General Provisions), unless Grantee meets the following Communications Act requirements: • clearly and conspicuously notifies the contributor or donor that the station may release its Personal Information to Nonaffiliated Third Parties; • advises contributors or donors before any disclosure, that they have the right not to have their Personal Information disclosed; and • explains to the contributor or donor how to exercise that non-disclosure option (47 U.S.C. § 396(k)(12)). Does Grantee disclose the Personal Information of contributors or donors to any Nonaffiliated Third Party? If yes, how does the Grantee provide notification to contributors or donors (such as posting on the station's website or advising the contributor or donor using written correspondence or email)? (500 characters)
Donor Information. SECTION A: for Individuals only DONOR 1 DONOR 2 Title First Name Initial Last Name Title First Name Initial Last Name Same address as Donor #1? Address: including PO Box, street address, suite or apartment number Yes No — If, complete below Address: including PO Box, street address, suite or apartment City State Zip number Phone Home Phone Business Cell Phone City State Zip Email Address (required) Phone Home Phone Business Cell Phone Home Church Email Address (required) Address Home Church Address SECTION B: for Organizations & Trusts only Organization Name Contact Name Tax Identification Number Trust Name Address: including PO Box, street address, suite number Trustee Name City State Zip Email Address (required) Phone Number Website
Donor Information. The Foundation shall be under no obligation to provide donor 65 information, including contact information, to the District or any other third party and 66 such information shall be kept confidential by the Foundation as requested by donors or 67 as deemed appropriate under the circumstance by the Foundation. 68
Donor Information. Fill out all that apply and indicate those that do not apply. Last Name Mailing Address First Name Maiden Name Phone Number Email Have you donated before? Yes No Are there any notes about your contact information? FOIP Statement This personal information is being collected under the authority of section 33(c) of the FOIP Act and will be used for administration purposes and to enhance the research value of the donated records. All information collected by the City of Edmonton is protected by the provisions of the FOIP Act. You may direct your questions about the collection, use, or disclosure of your personal information by contacting the City of Edmonton Archives at (000) 000-0000. Source of Materials Creators Please list all the creators of the material being donated. In instances of published material, the creator could be the one responsible for collecting it. Fill out all that apply. If you require more space please include it at the end. Creator Name: Include the full name, including middle name and maiden name if possible. Creator Contact Info: If possible, provide the Creator’s contact information Creator Type: Individual | Family | Corporate Entity Circle the one which best applies. Bio/Admin History Provide as much background information as possible. For individuals and families this can include dates and places of birth/death, education, occupations, etc. For corporate entities this can include mission, mandate, business area, and dates of founding, incorporation, and dissolution. Creator Name: Include the full name, including middle name and maiden name if possible. Creator Contact Info: If possible, provide the Creator’s contact information Creator Type: Individual | Family | Corporate Entity Circle the one which best applies. Bio/Admin History Provide as much background information as possible. For individuals and families this can include dates and places of birth/death, education, occupations, etc. For corporate entities this can include mission, mandate, business area, and dates of founding, incorporation, and dissolution.
Donor Information. Donor 1 (NOTE: all correspondence will be sent to Donor 1 unless otherwise specified) Full name (first, middle, last) Preferred name Preferred salutation (e.g. Xx. Xxxxx X. Smith or Xxx Xxxxx) Home address City State Zip Send mailings to my: Home Office Date of birth Business or organization name Position Business address City State Zip Phone (preferred) Email (preferred) Ethnicity* Donor 2 (NOTE: all correspondence will be sent to Donor 1 unless otherwise specified) Full name (first, middle, last) Preferred name Preferred salutation (e.g. Xx. Xxxxx X. Smith or Xxx Xxxxx) Home address City State Zip Send mailings to my: Home Office Date of birth Business or organization name Position Business address City State Zip Phone (preferred) Email (preferred) Ethnicity* *If you would like to provide information on ethnicity/race, it helps us compile statistics on philanthropic giving. WELCOME TO THE COMMUNITY FOUNDATION FAMILY Estate or Deferred Gift Agreement DONOR INFORMATION (continued) Donor 3 (NOTE: all correspondence will be sent to Donor 1 unless otherwise specified) Full name (first, middle, last) Preferred name Preferred salutation (e.g. Xx. Xxxxx X. Smith or Xxx Xxxxx) Home address City State Zip Send mailings to my: Home Office Date of birth Business or organization name Position Business address City State Zip Phone (preferred) Email (preferred) Ethnicity* Donor 4 (NOTE: all correspondence will be sent to Donor 1 unless otherwise specified) Full name (first, middle, last) Preferred name Preferred salutation (e.g. Xx. Xxxxx X. Smith or Xxx Xxxxx)) Home address City State Zip Send mailings to my: Home Office Date of birth Business or organization name Position Business address City State Zip Phone (preferred) Email (preferred) Ethnicity* *If you would like to provide information on ethnicity/race, it helps us compile statistics on philanthropic giving.
Donor Information. Donor 1 (NOTE: all correspondence will be sent to Donor 1 unless otherwise specified) Full name (first, middle, last) Nickname Preferred salutation (e.g. Xx. Xxxxx X. Smith or Xxx Xxxxx) Home address City State Zip Date of birth Business or organization name Position Send mailings to my: Home Office Business address City State Zip Preferred phone Preferred Email Donor 2 (NOTE: all correspondence will be sent to Donor 1 unless otherwise specified) Full name (first, middle, last) Nickname Preferred salutation (e.g. Xx. Xxxxx X. Smith or Xxx Xxxxx) Home address City State Zip Send mailings to my: Home Office Date of birth Business or organization name Position Business address City State Zip Preferred phone Preferred Email Estate or Deferred Gift Agreement (page 2 of 4)
Donor Information. Primary Donor Name Tax I.D. or Social Security Number (if applicable) Date of Birth: mo/day/year (if applicable) Email Address Address ( ) ( ) City ( ) State Zip Home Phone Business Phone Mobile Phone Preferred Method of Contact for the Primary Donor (check one) □ Email □ Home Phone □ Business Phone □ Mobile Phone □ Mail Joint Donor (if applicable) Name Tax I.D. or Social Security Number (if applicable) Date of Birth: mo/day/year (if applicable) Email Address Address City State Zip ( ) ( ) ( ) Home Phone Business Phone Mobile Phone Preferred Method of Contact for the Joint Donor (check one) □ Email □ Home Phone □ Business Phone □ Mobile Phone □ Mail
Donor Information. All correspondence will be sent to both donors unless otherwise noted. Quarterly Fund Statements will be mailed to the address listed and posted to the online Donor Portal. Donor 1 First Name MI Last Name Suffix Preferred Salutation (e.g. Xx. Xxxxx X. Smith or Xxx Xxxxx) Home Address City State Zip Work Organization Work Title Date of Birth Preferred Email Preferred Phone Donor 2 First Name MI Last Name Suffix Preferred Salutation (e.g. Xx. Xxxxx X. Smith or Xxx Xxxxx) Home Address City State Zip Work Organization Work Title Date of Birth Preferred Email Preferred Phone 2 Charitable Organization Information Designated Funds may be endowed or fully spendable. Such funds are earmarked for one or more charitable organizations, and all grants made will be made to (or for the use of) the designated recipient organization(s). When establishing a Designated Fund, donors specify one or more organizations to receive a regular distribution from the fund in perpetuity. A donor may establish a Designated Fund for the benefit of XYZ Charity and name the executive director of the charity as the fund's advisor. The executive director would have the customary advisory privileges associated with the fund. Charitable Organization Name Federal EIN Primary Contact for Organization (NOTE: All correspondence will be sent to the Primary Contact unless otherwise specified.) Salutation First Name MI Last Name Suffix Address City State Zip Position Business Phone Mobile Phone Preferred Email If the recipient organization ceases to exist or changes its status or mission as a charitable organization, the Foundation's Board of Directors may exercise its variance power, selecting an alternate use for the fund compatible with its original charitable purpose. If the designated organization merges with another organization, the entity resulting from such a merger shall succeed to the rights, powers, and privileges of the organization under this Agreement, but only if such resulting entity is a 501(c)(3) organization. If the resulting entity is not a 501(c)(3) organization, the Foundation shall proceed as if the designated organization was dissolved.
Donor Information. CSEA 262 CSEA 651 Faculty Confidential Supervisory Management _ Employee Name Employee ID Job Title By signing this agreement, I authorize the District to transfer hours of eligible leave credits from my available vacation leave balance and hours of eligible leave credits from my available sick leave balance to the CSEA 262 Catastrophic Leave Bank. In addition, I wish to designate as the recipient of this donation. (optional) (must be CSEA 262 unit member) I acknowledge that this donation is completely voluntary and I understand that this transfer is irrevocable. Any unused designated leave credits will not be returned to me and will become available for future CSEA 262 catastrophic leave recipients. Employee Signature Date Submit completed and signed form to the Payroll Department, Building 4, Room 1370 Payroll Certification This donation request has been: Accepted The employee’s donation of hours of vacation leave and hours of sick leave has been deducted and transferred to the CSEA 262 Catastrophic Leave Bank. Rejected The employee’s donation could not be processed for the following reason(s): _ Processed By (Print Name) Signature Date Payroll Use Only: Original to Employee File Copy to Employee Revised 6/30/15
Donor Information. The collection was donated to the State Historical Society of Missouri by Xxxxxx Xxxxxx on 1 October 1938. INDEX TERMS Subject Folders Xxxxxx, Xxxxxx 1 Xxxxxx, Xxxxxx X. 1 Xxxxxxx, Xxxxxxxxx Xxxxxx (1845-1926) 1 Xxxx, Xxxxxxx X. 1 Xxxxx, Xxxxx 1 Freemasons 1 Xxxxx, Xxxx X. 1 Xxxxxxxxx, Xxxxx X. 1 Masonic Home of Missouri, 1886 1 Xxxx, Xxxxxxx X. 1 Xxxxxxxxx, Xxxxxx X. 1 Xxxxxx, Xxxx X. 1
