Charitable Foundation of the Islands and our partnering nonprofit agencies are grateful for your kindness and support. In order to properly allocate funds to your specifications, please fill out this form. Thank you for trusting CFI to be the conduit of support on Sanibel and Captiva Islands.

Name of Donor Advised Fund

As the Advisor to the above-referenced Fund, I recommend that the Charitable Foundation of the Islands consider the following grant to (fill in agency name)

Agency Contact Person and Title

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

Email of Agency Contact

Grant Amount

Purpose of Grant (Please check one)

General Operations

Capital Contribution

Special Program

Special Instructions

I/we understand that this recommendation is advisory only and the final authority for all distributions is made by the Charitable Foundation of the Islands, whose authority it is to ensure that all grants are made for charitable purposes, consistent with IRS guidelines. I/we attest that this recommendation does not represent payment of a pledge or other personal financial obligation on behalf of the Fund's representatives, donor, advisors, family members or related parties and/or businesses that they control. Also, that no tangible benefit, goods & services (e.g. membership, dinners, tickets, etc.) were or will be received by any individual or entities connected with the Fund.

Name

First Name

Last Name

Name

First Name

Last Name

Date

YYYY

If you wish to provide an additional grant, please submit a separate form.

Donor-Advised Fund Distribution Request

Charitable Foundation of the Islands

For more information, contact:

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