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FREEPORT -MCMORAN FOUNDATION
Matching Gifts Program Application Form
Eligibility requirements and other important information on the Freeport-McMoRan Foundation Matching Gifts Program included on the attached Program Description.
Please Type or Print Clearly
Part I: To be completed by employee, director, retiree or full-time consultant and mailed with the gift to the eligible institution (see definition above).
DONOR Employee Director (active or retired) Retiree Full-time Consultant
NAME _______________________________________________________________________________________________________________
MAILING
ADDRESS ___________________________________________________________________________________________________________
Street Address or P.O. Box City State Zip Code
EMPLOYEE’S DIVISION _______________________________________ EMPLOYEE NUMBER ___________________________________
NAME OF ELIGIBLE
INSITITUTION _________________________________________________________________________________________________________
AMOUNT AND Check or credit card $ ____________________
FORM OF GIFT
(Must be Securities with market value of $ ____________________
unrestricted
as to use). Total value of this gift $ ____________________
If securities __________________________________________________________________________________________
Number of Shares and Description
DATE OF GIFT _____________________________ SIGNATURE OF DONOR ___________________________________________________
Part II: To be completed by an authorized officer of the receiving institution and mailed to Freeport-McMoRan Foundation.
NAME OF
INSTITUTION _____________________________________________________ Telephone: ( __________ ) ____________________________
MAILING
ADDRESS ___________________________________________________________________________________________________________
Street Address or P.O. Box City State Zip Code
TYPE OF Museum, Library, Art Gallery Public School (K-12)
INSTITUTION Orchestra, Theatre, other Performing Arts Private, Elementary School
United Way or Community Fund Private, Secondary School
Social/Community Service College or University
Environmental Alumni Fund or Foundation
Hospital State or Regional Assoc. of Private Colleges
National Fund or Assoc. for Education
EDUCATIONAL INSTITUTION ACCREDITED BY ____________________________________________________________________________
I certify that (a) the above named institution is tax exempt, (b) qualifies as an eligible institution as defined in the program description, and (c) the
total value of this gift as indicated above was received on ______________________________________________________________________
Federal Taxpayer’s Identification Number ___________________________________________________________________________________
Mr.
Name of Certifying Officer: Ms. ________________________________________________ Title: _______________________________
Signature of
Certifying Officer: _________________________________________________________________ Date: _______________________________
When Parts I and II have been completed, please mail to: YOU MUST attach the following:
1. A copy of the face of the check, credit card receipt or securities; and
Freeport-McMoRan Foundation 2. A copy of the letter granting your institution 501(c)3 status.
Matching Gifts Officer
P. O. Box 61119
New Orleans, LA 70161 Note: All applications for any calendar year must be received in our office
by January 31 of the following year to be considered for a matching gift.
For FM Foundation Use Only:
Date Application Received: Approved By: Check # and Date: Date Check Mailed:
(Revised 12/01)
Description of Program
FM Foundation’s Matching Gifts Program was established to encourage employee contributions to hospitals, community funds,
educational and cultural institutions, social service community organizations and environmental organizations and is an impor tant
part of the Foundation’s overall contributions program. The Foundation will match employee gifts of $25 or more, up to an an nual
maximum of $20,000. Gifts up to $500 per institution will be double matched, subject to the annual maximum, and except as
indicated as below. All gifts must be unrestricted.
Eligible Individuals
Employees of Freeport-McMoRan Copper & Gold Inc. (FCX), FM Services Company (FMS), and McMoRan Exploration Co. (MMR)
or divisions, subsidiaries, or affiliates of the above companies, retirees who retired directly from active service with the above
companies, full-time consultants, directors, and retired directors of the above companies are eligible to participate in the Program.
Eligible Educational Institutions and Alumni Associations
Any accredited graduate or professional school (including separate schools within a single university). Four-year college, two-year
junior or community college, public schools (K-12), or private elementary or secondary school (operated and controlled by an
independent board of trustees) that is located in the United States, whether supported privately or by taxation, is eligible.
Accreditation is determined by the appropriate nationally recognized regional or professional association, e.g., Southern
Association of Colleges and Schools. Alumni associations or funds established to receive contributions for education purpose s
solely in support of the school with which they are associated are also eligible. In addition, state or regional association s of private
colleges and national associations or funds soliciting support for education are eligible.
Eligible Cultural Institutions
Public and other tax-exempt cultural organizations such as museums, libraries, art galleries, orchestras, opera, dance, theatre,
historical associations, public radio and television stations, and botanical and zoological societies located in the United S tates are
eligible.
Other Eligible Institutions
All hospitals are eligible. Social service community organizations (such as Boys’ and Girls’ Clubs and Covenant House) and
environmental organizations (such as The Nature Conservancy) are eligible. Also the United Way/Community Funds are eligible,
but for single matching only.
Ineligible for Matching Gifts
Gifts ineligible for matching include benefits; tuition, housing or travel subsidization, or similar items; subscription fees for
publications, insurance payments, dues, payments for clubs or fraternities; support of athletic programs (such as constructio n of
athletic stadium or athletic scholarships); gifts directly to religious institutions or gifts intended to fulfill pledges, ti thes or other
religious-related financial commitments; gifts made with funds provided to donor for donation purposes by other persons; gifts to
donees not recognized by the IRS as institutions to which contributions are deductible.
Forms of Contributions
Contributions must be a personal gift of the eligible individual in the form of a check, credit card payment, or securities with a
quoted market value, not merely a pledge. Securities will be valued on the basis of the last sale or published closing price on the
date of the gift.
How the Program Operates
A) Donor completes Part I of this form and sends the entire form to the eligible institution with his or her contribution.
B) The financial officer of the eligible institution completes Part II and mails the entire form to Freeport-McMoRan Foundation in
New Orleans, together with the required substantiation.
C) The foundation verifies eligibility of the donor and of the school or organization and mails a matching check.
D) The Foundation notifies the donor when the matching gift has been transmitted to the eligible institution.
Conditions
Any questions regarding matching gifts should be addressed to the Freeport-McMoRan Foundation in the New Orleans office. Any
matters relating to the interpretation and scope of this Program of final determination of a question relating to the eligibi lity of an
educational or other institution to receive a matching gift will be decided by the Foundation and such decision shall be fina l. The
Program may be suspended, terminated at any time, or amended at any time.
Special Notice to Receiving Institutions
A) The receiving institution must submit a photocopy of designation as a 501(c)(3) institution (letter from the Internal Revenue
Service). Also, you will be contacted by our accounting department to submit a W -9 Form verifying your tax ID number. You
must also submit a photocopy of the original donation check, credit card receipt, stock certificate or stock transfer notification.
B) All matching gifts from the Freeport-McMoRan Foundation above $250 must be acknowledged with the amount of the
matching gift noted. Acknowledgement forms will be mailed to you and should be completed and returned to the matching
gifts office within ten (10) days of receipt of our matching gift check.
C) If a donor has received goods and/or services as a result of a donation, the value of the goods and/or services received must
be noted. The Foundation will match only the portion of the donation on which no goods or services are received.
(Revised 12/01)
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