UW System Administration Trust Funds DepositGift Receipts Form

							UW System Administration Trust Funds Deposit/Gift Receipts Form
Department Contact e-mail address Project Number Last Four Digit of Account 07 Project Name Department Name 161 162 Intermediate Fund Long Term Fund Phone Number

Department UDDS

Fund Investment Fund

Income Cash

Total Deposit Amount Check Amount Same as above, if depositing one check

Donor Name

Donor Address Line 1

Donor Address Line 2

City, ST

Zip Code

Principal Investigator Signature Chair/Director Signature Dean/Division Signature

Not Needed Date

Date

Date

Check Amount

Donor Name Donor Address Line 2 Zip Code

Donor Address Line 1 City, ST

Check Amount

Donor Name Donor Address Line 2 Zip Code

Donor Address Line 1 City, ST

Check Amount

Donor Name

Donor Address Line 1 City, ST

Donor Address Line 2

Zip Code

Check Amount

Donor Name Donor Address Line 2 Zip Code

Donor Address Line 1 City, ST

Check Amount

Donor Name

Donor Address Line 1 City, ST

Donor Address Line 2 Zip Code