IRA Charitable Rollover - Sample letter


Request from donor for direct charitable distribution
from an individual retirement account

Date
Name of IRA Administrator
Address
City, State ZIP


RE: Request for Direct Charitable Distribution from IRA

Dear IRA Administrator: 

Please accept this letter as my request to make a direct qualified charitable distribution from my individual retirement account number [insert number here] as provided for by the Protecting Americans from Tax Hikes Act of 2015 and Sec. 408(d)(8) of the Internal Revenue Code of 1986, as amended for the 2015 calendar year.

Please issue a check in the amount of $___________, payable to:

___Good Samaritan Foundation (Tax ID 91-2004312)
___Mary Bridge Children's Foundation, (Tax ID 94-3030039)
___MultiCare Health Foundation (Tax ID 91-1514257)
___South King Health Foundation (Tax ID 46-5636491)

and mail it to: 

Foundations of MultiCare
Attn: Frank Colarusso
PO Box 5296, MS 409-1-PHIL
Tacoma, WA 98415-0296

In your transmittal to the above named charitable organization, please memorialize my name and address as the donor of record in connection with this transfer, and copy me on the transmittal at the address below. 

It is my intention that this gift complies with IRC 408(d)(8). It is also my intention to have this transfer qualify during the 2016 tax year. Therefore, it is imperative that this distribution be postmarked no later than Dec. 31, 2016. If you have any questions or concerns regarding this request, I can be reached at [insert your telephone number and/or email address]

Thank you for your prompt attention to and assistance in this matter. 

Sincerely, 

Name of donor
Donor’s address
City, State ZIP
Donor’s phone number

Good Samaritan Foundation
253-697-5090

Mailing Address:
PO Box 5296
Tacoma, WA 98415-0296

Building Address:
401 15th Avenue SE
Puyallup, WA 98372

Non-profit 501(c)3
EIN/Tax ID 91-2004312

Mary Bridge Children's Foundation
253-403-1599

Mailing Address:
PO Box 5296
Tacoma, WA 98415-0296

Building Address:
409 South J St
Tacoma, WA 98405

Non-profit 501(c)3
EIN/Tax ID 94-3030039

MultiCare Health Foundation
253-403-1236

Mailing Address:
PO Box 5296
Tacoma, WA 98415-0296

Building Address:
409 South J St
Tacoma, WA 98405

Non-profit 501(c)3
EIN/Tax ID 91-1514257

South King Health Foundation
253-545-2776

Mailing Address:
PO Box 5296
Tacoma, WA 98415-0296

Building Address:
202 N Division St, Plaza One
Auburn, WA 98001

Non-profit 501(c) 3
EIN/Tax ID 46-5636491

Copyright 2017 Foundations of MultiCare
multicare.org | Privacy Policy