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| This form must accompany all charitable contributions to the University of New Mexico or the UNM Foundation, Inc. Please make a copy for your records. Please refer to the Instructions Sheet below for more information about how to complete this form. | ||||||||||||||
Donor Name and Address Information | ||||||||||||||
| Donor Name | Donor Category | UNM ID Number | ||||||||||||
| Spouse Name | Organization Contact Name | |||||||||||||
| Home Address and Phone Number | Business Address and Phone Number | |||||||||||||
| Additional Donor-related Information | ||||||||||||||
Gift/Pledge Information | ||||||||||||||
| Transaction Type | Payment Type | Anonymous Yes No | Total amount or Value (US$) | |||||||||||
| Source Code or reported | Campaign Code | Will This Gift Be Matched? If Yes, By Whom? | ||||||||||||
| Gift Pledge Designation Information | ||||||||||||||
| Gift Amount | Non Gift Amount | Fund Code | Date Received | Gift Purpose Code | Yes, Acknowledgment of gift from the Foundation | |||||||||
| Is the use of this gift or pledge restricted by the donor in any way? Yes No If yes, please describe. For in-kind gifts, please describe the asset received, its value, and the source of the valuation. Refer to "Gifts of Tangible Personal Property" Policy 7110, UBP for further information. (If the value is $5,000 or more, independent verification of value must be attached) (Note: For in-kind gifts valued at $1,00.00 or more, a copy of the form must be sent to Plant Fund Accounting) | ||||||||||||||
| Is this gift in honor or memory of anyone?
Yes No If yes, please provide the name and UNM ID if available. In Honor of In Memory of | Were any goods or services provided to the donor in exchange for this gift? Yes No If yes, please provide a description and dollar value.
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| If this gift is in honor or memory of someone, please provide next-of-kin
contact information. | Should soft credit be awarded with this gift? Yes No If yes, name the entity and provide the UNM ID number if available. | |||||||||||||
| Form Prepared and Submitted for Acceptance by (signatures required) | ||||||||||||||
| Department | School/College/Program | Building | Phone | |||||||||||
| Form Prepared By | Date | Comment | ||||||||||||
| Name and Signature of Development Officer _____________________________ | Date | Name and Signature of Department Head _____________________________
| Date | |||||||||||
INSTRUCTIONS FOR COMPLETING THE GIFT/PLEDGE TRANSMITTAL FORM
Use this form to report and transmit all gifts, pledges, and pledge payments received by any University department. Please complete and send or fax to the
UNM Foundation, Inc. Gift Processing Section within five working days of receiving a gift, pledge, or pledge payment. This form is to be used to transmit
either actual gifts or pledge information to the UNM Foundation; or to report to the UNM Foundation gifts or private grants received and processed by a UNM
department (please check the appropriate box at the top of the form).
Complete this form for all gifts received. Gifts include true grants received from private sources. Do not report any grants or contracts from
any local, state, or federal agency or organization. Cash or check gifts or pledge payments received without this form will be deposited, but will not be
processed nor allowed to be spent until the necessary documentation is received.
Copies of all pertinent documents to include donation letters must accompany this form. The Gift Processing Section will send an official University
receipt to all donors of cash, check or credit card gifts confirming the tax-deductibility of their contribution. Receipts will not be sent for gifts of real
property, gifts-in-kind, or deferred gifts. In-kind gifts should be acknowledged by the receiving department, but should not include a confirmation of value
on the acknowledgment itself. Real property and deferred gifts must be coordinated with the Office of Major/Planned Giving (277-6543), Development
Office, and will be receipted by that unit. Real property gifts must be received by the UNM Foundation, not a University department or program.
Donor Name and Address Information
Please provide the complete name, address, and telephone number of the donor, and indicate how the receipt and acknowledgment letter should be formatted.
In the case of an organizational gift, list the name and title of a contact person within the organization. Acknowledgments and receipts will be sent
to this contact person, unless otherwise noted.
For donor category, select one of the following for individuals:
Alumnus, alumna Faculty Friend
Staff Estate/Trust
For organizations, select one of the following:
Business/corporation Charitable trust
Corporate foundation Foundation
Other organization
Whenever possible, include the UNM identification number from the Alumni/Development Information System (ADIS).
Gift/Pledge Information
Use separate forms for each donor. Gifts from many individuals to the same fund, where all the gifts or pledge payments are under $1,000, may be
transmitted with a single form. In this case, attach a typed listing of donor names, addresses, gift amounts, and gift dates so that accurate receipts may be
produced. Gifts of $1,000 and more must be transmitted on separate forms.
If the gift is matched, attach the companys matching gift form.The form must be signed by an approved staff member of the Gift Processing Section.
If the form was not provided by the donor, the Gift Processing Section will contact the donor and request the appropriate form.
For transaction type, select one of the following:
Gift Pledge Pledge Payment
For payment type, select one of the following:
Check Cash/currency Securities
Company product In-kind gift Credit card
Please indicate if the donor requests the gift to be kept anonymous. In this case, the donor will receive a gift acknowledgment and receipt, but future
references to the gift will indicate an anonymous donor.
Indicate the source code associated with the particular solicitation for this transaction. If not provided, the appropriate departmental miscellaneous
source code will be used.
If the gift, pledge, or pledge payment is part of a specific campaign, please provide the code for that campaign.
Gift/Pledge Designation Information
Indicate the gift amount and non-gift amount (that portion of the gift for which the donor receives some returned benefit and is not normally tax deductible).
If the gift, pledge, or pledge payment is to an existing fund, indicate the amount, fund code, date received, and purpose of the gift for each fund specified by the
donor. The fund code may be obtained from the Gift Processing Section.
For purpose code, select one of the following:
ad Academic division at Athletics
fc Faculty/staff compensation li Library
ln Loan funds ot Other restrictions
pb Property, building & equipment
ps Public service and extension
re Research
ur Unrestricted
If the donor desires to restrict the gift in any way, give a brief description of the restriction. Attach all supporting documentation.
For new pledges, attach Form UNMFDN101 New Donor Pledge Form signed by the donor or verified by the department head. For
pledge payments, provide a brief description of the pledge to insure the payment goes toward the correct pledge.
For in-kind gifts, note the actual or estimated valuation. Values reported must be substantiated by attached documentation. Recent bills of sale or independent
expert appraisals are acceptable. Where acceptable documents substantiating the value are unavailable, please indicate the value is unknown (these gifts will be
recorded at $1.00). For gifts of equipment donated by the manufacturer, documentation from the corporate financial office must be used. Appraisals made by
University personnel are unacceptable because the University is a party to the transaction (Note: in-kind gifts valued at $1,000.00 or more, a copy of this form
must be sent to Plant Fund Accounting).
If the gift is in honor or memory of another person, please name that person in the space provided for that purpose. These gifts require special
acknowledgment, which is the responsibility of the University Memorial staff officer in the Development Office.
If any goods or services were provided in exchange for this gift, list them and their fair market value in the space provided.
If any entities should be given soft credit for this gift, please name them in the space provided.
Form Prepared and Submitted for Acceptance By
Please provide the signature, typed name, department, and phone number of the person who prepared this form. For gifts under $1,000, the signature
of the department head is required. For gifts larger than $1,000, the signature of the appropriate dean, director, vice president, or departmental
development officer is required. Your gift(s) will not be processed without the required signatures.
Comments may be sent to UBPPM@UNM.edu
http://www.unm.edu/~ubppm
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