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Equifax Matching Gift Form

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					                     Equifax Matching Gift Form
Section A     To be completed by the Equifax donor/giver

To            ARC Foundation Charitable Trust - Head of the Hooch-Row for the Cure
              ____________________________________________________
                     (Name of recipient Organization / Agency)

Address       1425 Market Blvd. Suite 330 - #244
              ____________________________________________________
              ____________________________________________________
              Roswell, GA 30076


I enclose the following contribution $ ______________
                                        (Minimum $50)

Donor’s Name ___________________________________________________
(type or print)
Donor’s Signature ________________________________________________
Employee ID # _______________ Employment Date __________________
Home Address ___________________________________________________
                ___________________________________________________
Equifax Location _________________________________________________
Business Phone __________________________________________________
   Company # ___________________ Department # __________________

Section B     To be completed by the recipient organization / agency.

Agency Name ____________________________________________________
Mailing Address __________________________________________________
                 __________________________________________________
Agency Category _______ Arts _______ Civic ________ ED ________ HHS
  Date Received ___________________
    Form of Gift ________ Cash ______ Check _______ Securities*
                           *# Shares _______________________________
                           Securities Title ___________________________
                           Market Value $ ___________________________
Amount of Gift $ ____________ (Please include a copy of your 501(c)3 letter)
Certified by _____________________________________________________
                            (Please type or print name)
 Signature _____________________________________________________
       Title _____________________________________________________

Return form to: Equifax Community Relations
                1550 Peachtree Street, N.W.
                Atlanta, Georgia 30309
The Equifax Foundation funds a Matching Gift Program which will effectively double the
contributions our employees to eligible nonprofit organizations within the areas of arts and
culture, health and human services, civic and community concerns and education.

Our Matching Gift Program and Philosophy

The Matching Gift Program is designed to enable employees, acting on their own initiative, to
direct a part of the foundation budget which reflects their personal philanthropic interests.
Individual gifts ranging from $50 to $5,000 per participant will be matched dollar for dollar each
calendar year. A Matching Gift form must be completed for each donation.

By involving more employees in the decision-making process, the Company is assured that
corporate giving will better reflect the values of its people and be more responsive to the local
needs of the communities where employees live and work.

Eligible Organizations

Not-for-profit U.S. organizations recognized by the Internal Revenue Service as tax-exempt under
Section 501 (c) (3) of the IRS code are eligible for matching gifts. These organizations include
arts and cultural institutions, civic and community organizations, health and human services
organizations and educational institutions.

Ineligible Organizations

Excluded from the Matching Gift Program are: individuals; labor, athletic, social, political, veteran,
fraternal and religious groups; fundraising benefits, dinners, exhibits, conferences and sports
events; charities sponsored solely by a single civic organization; and those organizations
identified by the Philanthropic Advisory Service of the Council of Better Business Bureaus as
having questionable financial practices.

Examples of organizations Equifax does not support are: organizations or programs which pose a
potential conflict of interest for the company; churches or religious organizations (however, non-
denominational programs sponsored by a church or religious group such as a camp, community
center, hospital, youth home, etc., are eligible); athletics including scholarships for college and
university athletic associations; athletic and band boosters, for-profit associations or social
organizations that provide a service like Junior Leagues, Kiwanis, Lions, Rotary, etc.

How To Make Your Matching Gift

Equifax will match gifts made in cash, stock or securities. The contribution must be given, not
merely pledged. Payment can be made by check, money order or securities. For securities, you
will need a photocopy of the securities certificate along with the Matching Gift form**.

Here are steps to participate in the Matching Gift Program:
       Complete Section A of the Matching Gift form and mail it with your gift directly to the
       nonprofit organization.

        That organization/agency/institution will then complete Section B of the form, enclose its
        501(c) (3) tax exempt approval letter from the IRS and return it to Equifax for the
        Company's matching gift.

        Equifax Community Affairs will process the returned forms, and send out checks to the
        recipient organizations. The employee will be notified that the match has been
        completed, or notified of any reason(s) the employee gift cannot be matched.

No gift can be matched without a completed form clearly filled out by each party. Equifax reserves
the exclusive right to determine the ultimate eligibility of all non-profit organizations.

				
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