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Donor-Advised-Fund-Agreement-20111

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					DONOR ADVISED FUND AGREEMENT
    Thank you for choosing Dry Creek Road. We are available to assist you full time with a variety of services
    from creating your Donor Advised Fund to handling the logistics and administrative requirements
    associated with making a charitable donation.

    This Agreement covers the information needed to establish a Donor Advised Fund. Please review the
    attached Procedures for Establishing and Operating Donor Advised Funds. If you have any questions
    about this agreement or the attached procedures, please call our Director Jon Moffitt at (801) 633-8853.



1       Donor Advisor Information
Donor Advisor 1* (required)

Name (First, Middle, Last)

Preferred Mailing Address                              City                       State                            Zip

Business or Organization Name

Home Phone                                             Business Phone                                            Email

Donor Advisor 2 (optional)

Name (First, Middle, Last)

Preferred Mailing Address                              City                       State                            Zip

Home Phone                                             Business Phone                                            Email

* All correspondence will be sent to Advisor 1, unless otherwise specified

2       Name of the Fund
Grants made to charities are accompanied by a letter which includes the name of the fund and the name and
address of the donor advisor. However, you may recommend that specific grants be sent anonymously.

Fund Name: _______________________________________________________________
    You may use our fund name in foundation materials including our website and annual report.
    We prefer our fund to be anonymous in public documents.




                2364 S Main Street, Salt Lake City, Utah 84115   www.drycreekroad.org   (801) 633-8853
3        Contributions
The minimum initial contribution to Dry Creek Road for a Donor Advised Fund is $1,000. Additional gifts can be
made in any amount. If making a contribution of multiple securities or assets, please attach pages as needed.

        Check for $_____________
        Publicly Traded Securities _____ shares of ______________________
        Other________________________________ (Please check with Dry Creek Road staff)

4        Fund Fees, Balance & Investment
Your fund will be invested at Moffitt Wealth Management according to investment policies created by Mark and
Ryan Moffitt and approved by the Dry Creek Road Board of Directors. Please indicate how you intend to operate
your fund:

        Intent to liquidate within the next year or two. These funds are placed in a money market account.

        Endowed fund: Intent to grow over time and use a portion of the fund annually.

There is no annual administrative fee for your fund.

5        Succession Plan
You may request that portions of your fund be administered in any or all of the following ways upon the death or
incapacity of the fund’s last surviving Donor Advisor. Total percentages should equal 100%.

 Succession option                                                                                 Percentage

 Transfer advisory privileges of this fund to Successor Advisor(s) as listed in this agreement.
 Transfer the fund’s assets to Dry Creek Road’s operating fund.
 Create an endowed designated fund for the benefit of the organization(s) named below. If you
 are starting a new fund there is additional paperwork and a $1,000 minimum requirement.
 Name(s) of organizations




 Other - please discuss with the Dry Creek Road staff.
                                                                                                   100%
 Total




                                                       Page 2
6       Successor Advisors
You may designate individuals as Successor Advisor(s), who have privileges to make recommendations
appropriate for the fund. You may choose up to two generations of Successor Advisors (each “generation” being
one successive advisor) before the funds are transferred as indicated above, and can change this designation any
time by completing a Successor Advisor Form available from the Foundation. It is the responsibility of the
designated Successor Advisor(s) to contact the Foundation at such time as he/she becomes Advisor(s) to the fund.
If we do not hear from the Successor Advisor(s) and are not able to locate him or her within twelve months of
becoming Advisor(s) to the fund, then the fund shall revert to Dry Creek Road’s operating fund.




                                                     Page 3
Successor Advisor 1 (optional)

Name (First, Middle, Last)

Preferred Mailing Address                            City                       State                           Zip

Home Phone                                           Business Phone                                           Email

Successor Advisor 2 (optional)

Name (First, Middle, Last)

Preferred Mailing Address                            City                       State                           Zip

Home Phone                                           Business Phone                                           Email

I/We, as the Donor(s), request that the Successor Advisor(s) named assume this responsibility:
_________on the following date: ______________
_________upon the death of the present Advisor(s)



6       Signatures
Donor Advisor(s) listed in section 1 must sign below

Policies and Procedures:

    The undersigned have received and reviewed the Policies and Procedures for Operating a Donor Advised
    Fund and agree to its terms and conditions. The undersigned understand that any contribution, once
    accepted by Dry Creek Road, represents an irrevocable gift to The Foundation and is not refundable. The
    undersigned hereby certify that all information presented in connection with this application is accurate and
    will promptly notify The Foundation in writing of any changes.

Fees

    Dry Creek Road does not charge any fees for its services in administering and distributing the funds. Service
    charges may apply.

Investments

    The undersigned understand that investments will be administered in accordance with the policies of Dry
    Creek Road and acknowledge that investments are subject to market and interest rate fluctuation risks. Any
    gain or loss generated by the above investments will be credited or charged to the fund. The total investment
    return of each investment vehicle is net of any investment fees.

Indemnity

    The undersigned hereby agrees to indemnify and hold harmless the Foundation, its directors, officers and
    other representatives, against any liability, cost, or expense which The Foundation may incur by reason if its
    acting upon recommendations given to the Foundation by any of the authorized persons named.



                                                       Page 4
Variance Power

   It is understood that the fund established by this agreement will be subject to the authority of the Dry Creek
   Road Board of Directors. Dry Creek Road reserves the right to modify the distribution of funds if in its sole
   judgment it is inconsistent with the charitable purposes of the Foundation.

Donor Advisor 1
___________________________________________________                                   ________________
Signature                                                                                         Date
____________________________________________________
Name (please print)

Donor Advisor 2
___________________________________________________                                   ________________
Signature                                                                                         Date
____________________________________________________
Name (please print)

Dry Creek Road
___________________________________________________                                   ________________
Signature                                                                                         Date
Jon Moffitt, Director




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