IRA/DAF Notification Form | University of Wisconsin Foundation

Please utilize this form to notify the University of Wisconsin Foundation of your intention to make either a Qualified Charitable Distribution gift from your IRA or a distribution from your Donor Advised Fund. Providing this information in advance allows us to identify your gift more quickly once it arrives and designate it to the use/fund directed by you.

Completing this form does not complete your gift; a separate request process should be initiated by you with your financial institution. This form is not intended as legal or tax advice

If you have any questions you can email [email protected] or call 800-443-6162.

Donor Information

Name*

First Last

Spouse/Partner Name

First Last

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone

Email*

Gift Details

Gift Type*

Donor Advised Fund (DAF)
Individual Retirement Account (IRA)

Name of Institution Which Manages Your DAF*

Account Name*

IRA Plan Trustee or Administrator Name*

IRA Plan Trustee or Administrator Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Amount*

Intended Area of Support*

CDIS Recognition Tile: Name, Dedication, or Phrase

If you are making a gift of $2,019 or greater to support the CDIS building campaign, please provide name(s), a dedication (in memory/honor), or phrase (‘On, Wisconsin!’ for example) for your recognition tile.

Consent*

I agree

The University of Wisconsin Foundation is a publicly supported charitable organization qualified to receive such rollover distributions qualified under 501(c)(3), 509(a)(1) and 170(b)(1)(A)(iv). It is my intention that this gift comply with the “qualified charitable distribution” requirements of Section 408(d)(8) of the Internal Revenue Code.

Schools & Colleges

UW’s Highest Priorities

UW Programs & Funds

IRA/DAF Request Form

Donor Information

Gift Details