Charitable Foundation Donation Request for Agents & Associates

Name(Required)

First Last

Address

Address Address Line 2 City State Zip Code

Email(Required)

Phone(Required)

Is this a Pass Through?(Required)

Yes

Comments/ Questions

Legal Organization Name per W-9 (payable to)(Required)

Is the organization a Non-Profit? Our charitable fund only makes donations to federally recognized nonprofits.(Required)

Yes

Contact Name

First Last

Title

Physical Location Address(Required)

Street Address Address Line 2 City State Zip Code

Phone

Which one of the RRI Charitable Foundation funding priorities will this support?(Required)

How will the funds be used?(Required)

Amount of Donation(Required)

Date the check is preferred by? (We’ll do our best to make this happen. If none leave blank)

Where should the check be sent? (Your name will be in the memo area and in a letter)(Required)

Mail the check to me

Mail the check directly to the non-profit