Office of Research and Sponsored Programs
Foundation Administration
Donation Payment Form
This donation is something given voluntarily without payment in return, as to show favor toward
an organization, or to honor an occasion, or make a gesture of assistance.
Please complete the information requested below and have the individual complete a Payee Data
Record form. We must have this form on file in order to process the donation payment.
Name:
_________________________________________
SSN or Tax ID: (last 4 numbers)
Address:
Donation Reason:
Donation Amount $:
Project Director’s Signature
Date
Rev 2/2007