HTML Preview Matching Gift Acknowledgement Letter page number 1.
MATCHING GIFT PROGRAM
PART A – TO BE COMPLETED BY EMPLOYEE/RETIREE (PLEASE PRINT OR TYPE)
Name Telephone
Address
Number Street City State Zip
Name of Recipient Organization
Special Purpose (if applicable)
Location
City State Zip Telephone
Contribution Amount $ Form of Gift: Check Credit Card
Credit Card Number Expiration Date
Certification of Employee/Retiree: I certify that I have read the requirements set forth in the Matching Gift Program Requirements (see next
page) and that the recipient organization and this contribution are fully eligible under the requirements.
Signature of Employee/Retiree Date
Please return a copy to Audrey T. Mento to register the gift.
PART B – TO BE COMPLETED BY RECIPIENT ORGANIZATION AND SENT TO SANDMEYER STEEL COMPANY
(PLEASE PRINT OR TYPE)
Legal Name of Recipient Organization
Address
Number Street City State Zip
Telephone EIN
Fax Email
Website Date of Gift
Gift Amount $ Tax Deductible Amount $
Certification of Recipient Organization: I certify that the gift described above was received. I certify that I have read the requirements set forth
in the Matching Gift Program Requirements on next page and that the recipient organization and this contribution are fully eligible under the
requirements.
Print Name Title
Signature Date
All organizations must submit the following information: Organization return forms to:
• 501(c)(3) determination letters from IRS Audrey T. Mento
• Brochure describing organization Sandmeyer Steel Company
• Letter of regional accreditation (for private educational institutions only) One Sandmeyer Lane; Philadelphia, PA 19116
Check box if already on file 215-698-4105 – AMento@SandmeyerSteel.com
For Office Use Only:
Confirmation Number: Date Check Number: Date