Xerox Employee Matching Gifts Program - Download as DOC by cyi51544


									Xerox Employee Matching Gifts Program
                                                                                                                                                Payments for tuition, books or other student fees.
To All Employees                                                   Employee
                                                                                                                                                Dues payable to national or local alumni groups.
Xerox believes that the healthiest and most efficient              a.         At the time of the contribution, the individual must              Subscription fees for publications.
solutions to social problems are pluralistic in nature--those                 be a qualified employee, which means a current
                                                                                                                                                Bequests.
receiving support from business, government, foundations                      employee, a director or a retired employee of Xerox
and individuals. This broad-based support ensures that                        Corporation.                                                      Restricted gifts such as family scholarship funds and
non-profit institutions are not beholden to the interests of                                                                                     athletic subsidies.
                                                                   b.         Spouses and domestic partners of qualified
any one group.
                                                                              employees are also eligible under the terms of the
                                                                                                                                                Libraries and museums affiliated with colleges and
                                                                              program.                                                           universities.
In an effort to encourage Xerox people to support non-
profit institutions of their own choice, Xerox provides
several opportunities for employee participation. One such         c.         For contributions to educational institutions, the         How the Program Operates
opportunity is the Xerox Employee Matching Gifts                              qualified employee, spouse or domestic partner need
                                                                              not attend the school designated.                              1. The employee should complete and sign Part A.
Your contributions to qualified four-year educational              d.         Where both the qualified employee and spouse or                2. The entire folder along with the contribution should
institutions, two year community colleges and junior                          domestic partner are contributing to the same                      be mailed to the designated institution.
colleges are matched by Xerox according to the guidelines                     institution, the combined total of their gifts eligible
                                                                              for matching cannot exceed $1,000.                             3. An authorized official of the organization should
described in this brochure. We hope you will read it and                                                                                         complete and sign Part B thereby certifying the
consider the Matching Gift program when you make your
charitable decisions.                                              Educational Institutions Eligible                                             receipt and intent of the gift in accordance with the
                                                                                                                                                 conditions of the program. The form should be
                                                                   a.         The institution must offer a four-year or a two year               returned to:
General Provisions of the Programs                                            degree, and be located in the United States or in a                The Xerox Foundation
The Xerox Foundation will match employee gifts, ranging                       U.S. possession. Such institutions would normally                  45 Glover Avenue - 6th Floor/P.O. Box 4505
from a minimum of $25 to a maximum of $1,000 per                              include universities, colleges, graduate schools and               Norwalk, Connecticut 06856-4505
institution each calendar year on a one-to-one basis. The                     technical institutes which are accredited or approved
                                                                              by a nationally recognized accrediting agency.                 4. The Foundation will match eligible requests for
contribution must be to qualified four-year educational                                                                                          matching gifts periodically during each calendar
institutions or a two year community or junior college.            b.         Alumni funds, foundations or associations are also                 year. Checks will be mailed to the President or
The Foundation will match up to the maximum limit of                          eligible, provided they are properly certified by the              managing director of the institution on an
$1,000 for as many institutions as the employee wishes to                     institution with which they are affiliated and are                 unrestricted basis.
assist. To be eligible, under the terms of this program, an                   recognized by the Internal Revenue Service as
                                                                              organizations to which contributions are deductible            5. The interpretation, application and administration of
organization must be tax-exempt as defined by the Internal                                                                                       the provisions of the matching gifts program shall be
Revenue Service of the United States Treasury Department.                     for Federal Income Tax purposes.              National,
                                                                              regional, state and intercollegiate associations whose             determined by the Board of Trustees of The Xerox
                                                                              primary goal is financial support of higher education              Foundation and its decision shall be final.
                                                                              (e.g., New England College Fund, Independent
                                                                                                                                             6. Questions regarding the program should be directed
a.     A gift must be an actual contribution made, not a                      Colleges of Southern California, etc.) are also
                                                                                                                                                 to: President, The Xerox Foundation, 45 Glover
       pledge, and can be cash or securities at market value                  eligible.
                                                                                                                                                 Avenue, Norwalk Connecticut 06856-4505.
       on the date of transfer.
                                                                   Gifts Not Qualified For Matching                                          7. Forms can be obtained through the Forms
b.     If securities are given, the value will be determined
                                                                                                                                                 Management internal website in Rochester, The
       to be the last sale or published bid price on the date      The Xerox Foundation will not match:
                                                                                                                                                 Xerox Foundation, or from your Human Resources
       of the gift.                                                          Gifts to public or private elementary and secondary                office.
                                                                             Gifts to educational institutions that are not fully

Part A - Employee                                                                                           Part B - To Be Filled Out by the Organization
Fill out this part and mail entire folder along with your contribution to the                                                             The Xerox Foundation
named organization.                                                                                         Fill out this part of the
                                                                                                                                          45 Glover Avenue - 6th Floor/P.O. Box 4505
                                                                                                            form and mail to:
                                                                                                                                          Norwalk, CT 06856-4505
Enclosed is my personal gift of $                                      Date
                                                                                                            I hereby verify receipt of the above-stated gift:
If securities, etc. include value
                                                                                                            Name of Institution
Name of organization
I hereby authorize the above named organization to verify this gift and                                     President or Managing Director’s Full Name
report it to The Xerox Foundation, Norwalk, Connecticut, for the
purpose of qualifying for a contribution under its Matching Gifts                                           Title
Program. I am currently employed by Xerox Corporation or a Xerox
Company.                                                                                                    Address

Full name of contributor                                                                                    City                                                               State        Zip

Name of employee, if spouse or domestic partner is contributor
                                                                                                            Signature                                                          Date

Employee #
Department and/or Subsidiary
                                                                                                            Phone No.

Work Address
                                                                                                                               This document must be accurate and complete.
                                                                                                                             Please print or type. Do not submit electronically.
City                                                            State          Zip

Signature                                                       Date
Form 56673 (3/2010) Human Resources

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