DONOR APPLICATION

Complete this form, a “Contribution Agreement” and an “Investment Allocation” to establish a donor-advised fund
with CCFGiving. Additional forms are available at ccfgiving.com. If you need assistance, call toll-free at (866) 320-9275 or
send an email to info@ccfgiving.com.

1. Donor-Advised Fund Name

Choose a name for your donor-advised fund. You may name it for yourself, for your family (“The Brown Family Charitable Fund”),
in memory of someone, or for a particular charitable purpose (“The Annual Seminarian Fund”).

Donor Advised Fund Name

2. Choose Your Account Type

m GENESIS
$0 minimum balance; must contribute $5,000 within 36 months; maximum of 15 grants per year; grants must be a minimum
of $25; online tech support only; yearly fee of $120

m COVENANT
$5,000 minimum balance; unlimited grants per year; grants must be a minimum of $25; full support from CCFGiving
Fund; yearly fee of $250 or 60 basis points (whichever is greater)

m KINGDOM
$1,000,000 minimum balance

3. Initial Contribution Amount

$
Initial Contribution Amount

4. Contribution Transfer Instructions

m Check
Please mail your check to:
CCFGiving
PO Box 4525
NY, NY 10163
Tax ID#: 81-5466677

m Wire Transfer
Cash contributions may be made via wire transfer. Please follow these instructions when making a wire transfer:
Bank: J.P. Morgan Chase Bank, N.A.
Bank Routing Number: 021000021
Name on Account: CCFGiving
Account Address: 757 3rd Avenue, 21st Floor | New York, NY | 10017
Account Number: 198355726
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 m Securities
Contributions may be made in the form of securities. If you wish to contribute to your DAF in this manner, please
follow these instructions:
DTC: 0504
Name on Account: CCFGiving
Account Number: U2238694

Name of Stock Trading Symbol # of Shares

Name of Stock Trading Symbol # of Shares

Name of Stock Trading Symbol # of Shares

5. How Would You Like To Receive Information From CCFGiving?

m Go Green! View statements and receive correspondence online
m Receive correspondence via mail

6. Primary Advisor
Identify the Primary Advisor for the fund (typically, this is also the Primary Donor to the fund).

m Mr. m Mrs. m Ms. m Dr.

First Name, MI, Last Name Date of Birth

Street Address City/State Zip

Email Primary Telephone #

7. Joint Advisor
You may name an individual (such as a spouse, family member, friend or other) as Joint Advisor to your fund who also has the
authority to recommend grants and investment allocations, view fund information and name successors. They will assume
the role of Primary Advisor to the account in the event of the death of the Primary Advisor.

Would you like to name a Joint Advisor to your fund at this time?
m Yes m No

m Mr. m Mrs. m Ms. m Dr.

First Name, MI, Last Name Year of Birth

m Same address as Primary Advisor

Street Address City/State Zip

Email Primary Telephone # CCFGiving FOR DAFI 2107

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8. Secondary Advisor(s)
You may name Secondary Advisors to your fund who will have the authority to recommend grants. Secondary
Advisors will not succeed the Primary and Joint Advisors unless they are named as Successors in Section 6A.
To indicate additional Secondary Advisors, you may attach a separate sheet.

Would you like to name a Secondary Advisors to your fund at this time?
m Yes
m No

m Mr. m Mrs. m Ms. m Dr.

First Name, MI, Last Name Year of Birth

m Same address as Primary Advisor

Street Address City/State Zip

Email Primary Telephone #

9. Financial Advisor
You may name a Financial Advisor to your fund if you wish to do so. A Financial Advisor may be given read-only
account access or the authority to recommend investment allocations and recommend grants on the Primary/Joint
Advisor’s behalf.

Financial Advisor Name Financial Institution

Street Address City/State Zip

Email Primary Telephone #

10. Succession Plan

You may name a/an individual(s) as successor advisor(s) to continue your charitable legacy in the event of death
or incapacitation of both primary and joint advisors and/or you may elect to name specific charities as the
Charitable Beneficiaries of the fund. These recommendations may be changed at any time. To indicate additional
Successor Advisors or Charitable Beneficiaries please contact us at info@ccfgiving.com.
If you do not select a succession plan, the balance of your fund will be assumed into the general fund of CCFGiving.
Once your fund is established you can added your succession plan through our secure donor portal.

A. I wish to name Successor Advisors

m Option 1: Retain assets in fund; Successors will share fund administration; OR
m Option 2: Create new separate funds, and divide assets equally among Successors.
m Mr. m Mrs. m Ms. m Dr.

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 First Name, MI, Last Name % of Funds Year of Birth

Street Address City/State Zip

Email Primary Telephone #

m Mr. m Mrs. m Ms. m Dr.

First Name, MI, Last Name % of Funds Year of Birth

Street Address City/State Zip

Email Primary Telephone #

B. I wish to elect charities as the Charitable Beneficiaries of the funds

When you pass away, if any of the charities listed below no longer exists, CCFGiving will do our best
to find a comparable replacement with a similar mission.

m Option 1: Distribute all of the remaining assets in the fund to the following charity(ies); OR
m Option 2: Designate a specific percentage to be annually distributed to the charity(ies).

Charity Name Annual % (Option 2 only)

Street Address City/State Zip

Contact Name Employer ID # (if known) Primary Telephone #

Charity Name Annual % (Option 2 only)

Street Address City/State Zip

Contact Name Employer ID # (if known) Primary Telephone #

11. Investment Allocation

m Option 1: Knights of Columbus Asset Advisors Model Portfolios
The following portfolios were prepared by Knights of Columbus Asset Advisors (KCAA) and range from
conservative to aggressive.

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 m Conservative
m Moderately Conservative
m Moderate
m Moderately Aggressive
m Aggressive

m Option 2: Create your own Portfolio

Limited Duration Bond % Core Bond %

Large Cap Growth % Large Cap Value %

Small Cap Equity % International Equity % Total

The total percentages should equal 100

12. Payment Information (Genesis Accounts Only)

For 36 months, Genesis accounts will incur a $10 monthly fee.

m VISA m Mastercard m AMEX m Discover m Other

Cardholder Name (as shown on card) Card Number

Expiration Date (mm/yy) Security Code Zip

Signature

13. Do you wish to place any restrictions on your fund, to protect how your fund may be used in
the event of your passing? If so, please inform us below

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14. Acknowledgment of Terms
(this section must be signed by the Primary Joint Advisor)
I understand that my gifts of property are irrevocable and unconditional contributions when received and accepted
by CCFGiving, and that CCFGiving retains exclusive legal control over contributed assets. I
acknowledge that I have read the CCFGiving Program Guide and agree to the terms and/or conditions contained therein.
I certify that, to the best of my knowledge, all information in connection with this application is accurate and I will
notify CCFGiving in writing of any changes.

Primary Advisor Signature Date

15. Return this completed form by mail or fax to:

CCFGiving | PO Box 4525 | New York, NY 10163 | Fax: (646) 365-3246

CCFGiving is a Delaware exempt non-stock, nonprofit corporation in the process of applying to the Internal Revenue Service for recognition of exemption under Section
501(c)(3) of the Internal Revenue Code. CCFGiving administers a donor-advised fund (“DAF”) program. The discussion herein regarding, among other things, DAFs is, and is
intended to be, strictly general, informational and educational in nature. It is not intended to be, and nor should it not be construed as, legal, tax, financial planning or other
professional advice. CCFGiving does not provide legal, tax, financial planning or other professional advice.
You should be aware that the availability of certain Federal income tax deductions may depend on whether an individual itemizes deductions and other considerations.
Moreover, the rules and regulations regarding state and local income tax deductions vary at the state and local level, and are constantly changing. CCFGiving disclaims
any responsibility for the accuracy or adequacy of any position taken by you in any Federal, state and local tax return, and you are strongly urged to consult licensed and
competent professionals providing legal, tax or financial planning advice or advice in any other area of practice relevant to you regarding your specific circumstances and
objectives.
Nothing on the Site shall be considered, and is not intended to be, a solicitation to buy or an offer to sell a security or any other product or service to any person in any
jurisdiction where such offer, solicitation, purchase or sale would be unlawful under the laws of such jurisdiction.
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computers, fraud and privacy. In addition, you agree to comply with all applicable laws, rules, codes and regulations regarding the transmission of technical data exported
from the United States.

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