4501 Employee Matching Gifts Form

W
Document Sample
scope of work template
							                                                 U.S. Bancorp Foundation
                                                EMPLOYEE MATCHING GIFT
                                                 PROGRAM GUIDELINES

U.S. Bancorp employees everywhere           Matching gift requests must be               – gifts that fulfill a prior obligation
are contributing to our communities with    received within one year of the gift         – items purchased at or donated to a
service, leadership — and through           date. Requests received after that will        silent auction, raffle or other
charitable contributions. These             not be honored.                                fundraising event
partnerships help make better places for
                                                                                       • Gifts to United Way or other
everyone to live, work, and grow. With      EMPLOYEE ELIGIBILITY
                                                                                         campaigns in which workplace
the Employee Matching Gift Program,         All regular full-time and part-time          solicitations are permitted and
the U.S. Bancorp Foundation supports        employees of U.S. Bancorp who have           supported by the Company, payroll
employees in their efforts to improve the   been employed for at least one year          deduction is permitted and the
community.                                  are eligible to apply.                       Foundation also contributes directly
MATCHING GIFT ALLOTMENT                                                                  to the campaign
                                            ORGANIZATION ELIGIBILITY
Employee Gift Matching: The                                                            • Gifts for political concerns or to
                                            Community Organizations                      organizations whose stated purpose
U.S. Bancorp Foundation will match
                                            The U.S. Bancorp Foundation will             includes lobbying, political activity,
an employee’s personal charitable
                                            match fully tax-deductible gifts to          litigation, or advocacy
contributions of cash (including check
                                            organizations that are tax-exempt public
or credit card payments) or stock in the                                               • Gifts to units of government (except
                                            charities pursuant to IRS section
amount of $50 or more. The maximum                                                       public schools)
                                            501(c)(3) located in the United States.
aggregate match per employee is
                                            Eligible organizations include the areas   • Gifts to organizations whose primary
$1,000 per calendar year.
                                            of: health and human services; arts and      purpose is religious, unless the
Nonprofit Board Members:                    culture; environment; museums; public        organization is nondenominational in
An employee who serves on the               radio and television; zoos; food banks;      nature and benefits a broad range of
governing board of an eligible 501(c)(3)    and youth development programs.              the community (such as a soup
nonprofit may apply for an additional                                                    kitchen or homeless shelter)
contribution amount matching his or her     Schools and Colleges
personal charitable cash contribution to    The Foundation will match fully tax-       • Gifts from donor-advised funds
that organization, up to an additional      deductible gifts to an accredited
                                                                                       • Gifts to private foundations
$2,000 per calendar year. The maximum       public or private K-12 school, college
aggregate match for employees on            (including junior college) or university   • Gifts to individuals or designated for
nonprofit boards is $3,000 per calendar     that is tax-exempt pursuant to IRS           the benefit of specific individuals
year.                                       section 501(c)(3) and located in the
                                            United States.                             • Gifts to organizations whose activities
                                                                                         represent a conflict of interest
TWO WAYS TO APPLY                           Ineligible Gifts and Organizations         • Gifts to any organization whose
Quick and Easy Online Process:              U.S. Bancorp Foundation will not             practices are not in keeping with the
• Employees may request a matching gift     match the following:                         corporation’s equal opportunity or
  online at the U.S. Bancorp Foundation     • Gifts that result in the employee or a     diversity policies
  Employee Matching Gift Program web          member of his or her family receiving
  site: www.easymatch.com/usbank.             a material benefit from the              • “Pooled” gifts, in which a number of
or                                            organization. Examples of these            employees or individuals combine
Paper-Form Process:                           benefits include:                          gifts to form a “group donation” to
                                                                                         a nonprofit organization. Each
• Employees complete the Employee            – tuition relief                            employee contributing to the
  Application section of the attached        – study, research or travel                 organization must complete his or
  form, sign it, and mail it to the            reimbursement                             her own matching gift form
  nonprofit organization.
                                             – extracurricular expense
• The organization then completes and                                                  The U.S. Bancorp Foundation reserves
                                               reimbursement
  signs the Gift Verification section                                                  the right to alter, suspend, or terminate
                                             – dues for alumni, athletic or any        the program and to determine the
  and mails the entire form to the
                                               other organizations or associations     eligibility of organizations to receive
  U.S. Bancorp Foundation Employee
  Matching Gift Program.                     – event admissions, tickets, or           funds.
                                               registration fees, including any fees
Eligible requests are processed on             for participation in a charity event
the following quarterly schedule:                                                      For more information, please visit
                                             – admissions to dinners, lunches,
                                                                                       the program website at
Received by:   3/1 6/1 9/1 12/1                or other gatherings
                                                                                       www.easymatch.com/usbank
Processed by: 3/31 6/30 9/30 12/31           – preferential seating, parking, etc.     or call 1-866-243-6925.
                                                    U.S. Bancorp Foundation
                                                EMPLOYEE MATCHING GIFT FORM

                 EMPLOYEE APPLICATION                                                NONPROFIT GIFT VERIFICATION
              Please complete this column and                                  Please complete this column and return to the
        mail this form to the nonprofit organization.                    U.S. Bancorp Foundation Employee Matching Gift Program.

Please provide all requested information and sign the form.              I certify that the nonprofit organization named below has
Incomplete forms will be returned to you.                                received a fully tax-deductible personal charitable contribution
                                                                         from:
Employee Name         ________________________________________________    ______________________________________________________
                                                                                              (U.S. Bancorp Employee)
6-Digit Employee ID       ____________________________________________
                                                                         of $ _______________ (cash or fair market value of stock gift)
Mail Code     ________________________________________________________
                                                                         on ____ /_____ /_____ (date gift received).
Daytime Phone       __________________________________________________
                                                                         Is this donor an active member of your governing board?
Email Address       __________________________________________________
                                                                         _______Yes ______No
Hire Date     ________________________________________________________
                                                                         If yes, enter the start date of board service _______ /________
                                                                                                                       (month) (year)
 I am applying for the following matching gift to:
                                                                         I further certify that this gift does not entitle the employee
 Organization Name       __________________________________________      or a member of his or her family to any material benefit
 Organization City, State      ____________________________________      from our organization.

 Restriction/Purpose (if any) __________________________________         This institution is recognized by the U.S. Treasury Department
                                                                         as one to which contributions are deductible by the donor for
 Gift Type:       Ë Cash/Check/Credit Card            Ë Stock            federal income tax purposes.
   __________________________________________________                    _______Yes ______No
        If Securities, Number of Shares and Name of Security
 Select and check one of the following options:                          REQUIRED: Attach a copy of your 501(c)(3) status letter
                                                                         from the IRS.
 K Employee Matching Gift
 I have paid or am enclosing a fully tax-deductible personal             ___________________________________________________________________
 charitable contribution of $___________ (cash or stock value)           Organization
 to the organization named above and request the U.S. Bancorp            ___________________________________________________________________
 Foundation to match $___________ of this contribution                   Federal Tax ID (EIN)
 (minimum: $50 per donation, limit: $1,000 per calendar year).           ___________________________________________________________________
 or                                                                      Address
 K Nonprofit Board Member (if applicable)                                ___________________________________________________________________
 I am an active, participating member of the governing board of          City, State, Zip
 the nonprofit organization named above. I have paid or am
                                                                         ___________________________________________________________________
 enclosing a fully tax-deductible personal charitable contribution       Telephone
 of $___________ (cash or stock value) to this organization and
 request the U.S. Bancorp Foundation to match $___________               ___________________________________________________________________
 of this contribution (limit: $3,000 per calendar year).                 Fax
                                                                         ___________________________________________________________________
I certify that I have read the program guidelines and have               Website Address
made an eligible gift.                                                   ___________________________________________________________________
                                                                         Name (please print)
I authorize the above-named recipient organization to report
this gift to U.S. Bancorp for the purpose of applying for a              ___________________________________________________________________
matching gift.                                                           Email Address
Signature     ________________________________________________________   ___________________________________________________________________
                                                                         Signature
Date   ______________________________________________________________                 Please return this entire form to:
Employees: Mail this form to the recipient nonprofit                                  U.S. Bancorp Foundation
                                                                                      Employee Matching Gift Program
organization to complete the Nonprofit Gift Verification section.
                                                                                      P.O. Box 8857 • Princeton, NJ 08543-8857
Forms received by the U.S. Bancorp Foundation Employee
Matching Gift Program after December 1 will be paid the                  If you have questions about this program or application,
following year.                                                          please call 1-866-243-6925.                        4501A (9/09)

						
Related docs