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STANFORD UNIVERSITY STANFORD UNIVERSITY

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					                                    STANFORD UNIVERSITY

                         AFFILIATE INCOME TRANSMITTAL FORM


              Checks over $5,000 and cash should be hand-carried to Gift Processing*
                                   Do NOT send via ID Mail!


MAIL TO:      Gift Processing, 326 Galvez St, M/C 5018

DATE:     _________________________________


COMPANY NAME:______________________________________ ID # (if known): ____________

AMOUNT:__________________


PFOO: ___________________________________ Title: __________________________________
(Fund/Award is required; Object and Owning Organization are helpful.)


ATTACHED:       _____ Check payable or endorsed to Stanford, in US Dollars, under 6 months old
                _____ Any donor correspondence
                _____ Original, postmarked envelope (required at all times of the year)


Comments or special instructions: _______________________________________________________

___________________________________________________________________________________

Department: __________________________________________ Mail Code: ___________________

Affiliate Program: ___________________________________________________________________

Contact Name: ________________________________________ Phone #: _____________________

Contact Email: ______________________________________________________________________

                             For questions, contact Gift Processing at 5-4360.
*Gift Processing is located in Frances C. Arrillaga Alumni Center, corner of Galvez St.& Campus Dr.




                                                                                       3/6/2010

				
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