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(date)
To the Board of Directors
King Baudouin Foundation United States, Inc.
10 Rockefeller Plaza, 16th Floor
New York, NY 10020
Re: Establishment of a donor-advised fund on the books of King Baudouin Foundation United States
Ladies and Gentlemen:
With this letter, we are delivering to you the property listed below. The delivery of this property constitutes an
irrevocable gift to the King Baudouin Foundation United States, Inc. (the “Foundation”) upon your
acceptance of the gift and the following terms and conditions:
Donor-Advised Fund Name
A fund shall be established on the books of the Foundation and be known as the:
………………………………………………………………………………… ("the Fund").
Objective of the Donor-Advised Fund
Consistent with the Foundation’s exempt purposes, the principal purpose of the Fund shall be to:
…………………………………………………………………………………………………
…………………………………………………………………………………………………
Description of Property Delivered to the King Baudouin Foundation United States
(The Fund shall include the property delivered with this letter and described below, and any other property which later may be
transferred to the Foundation by the donor(s) or other parties and accepted by the Foundation for inclusion in the Fund.)


Check or money order made payable to KBFUS.
$ ………………
(Make check or money order payable to KBFUS, write your Fund’s name in the memo section, and send to:
King Baudouin Foundation United States, 10 Rockefeller Plaza, 16th Floor, New York, NY 10020)
Wire transfer.
$ ………………
(Info for wire transfers: Citibank, 1 Rockefeller Plaza, New York, NY 10020; ABA: 021000089; SWIFT:
CITIUS33; Account Name: King Baudouin Foundation United States; Account Number: 9970182790)
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

Online contribution by credit card.
$ ………………
(Go to www.kbfus.org, click on the ‘Donate Now’ button on the homepage, and select your Fund’s name under ‘Giving
Option 2: KBFUS Donor-Advised Funds’. Note: A 3% credit card processing fee applies to all online donations)
Contributions of other types of property.
$ ………………
(Please contact KBFUS to discuss: Phone (212) 713 7660; Email info@kbfus.org)
Investment of the Fund’s Assets
(Assets of Donor-Advised Funds with fund balances over $15,000 may be allocated to one of four investment pools that were
selected by the Board of the Foundation. Alternatively, in case of fund balances over $100,000, the donor may make a nonbinding recommendation that the management of the assets be entrusted to an investment advisor or asset manager of their choice.
For more details, please see our Investment Policy Statement.)

We do NOT recommend that the Fund’s assets be invested.

We recommend that the Fund’s assets be invested and allocated to the following investment pool:




Growth Pool
Growth & Income Pool
Income Pool
Money Market Pool

We recommend that the Fund’s assets be invested and that the management of the assets be entrusted to
the following investment advisor or asset manager:
Name
Affiliation
Mailing Address
Phone
Email
……………………………..……………..…………………
……………………………..……………..…………………
……………………………..……………..…………………
……………………………..……………..…………………
……………………………..……………..…………………
Privilege of Making Grant Recommendations
(Note: Any person so designated shall be subject to various restrictions and obligations imposed by the Foundation in order to
assure compliance with the federal tax laws.)
We hereby designate the following individual to act on our behalf in submitting recommendations to the
Foundation for organizations and projects to be supported:
Name
Affiliation
Mailing Address
Phone
Email
……………………………..……………..…………………
……………………………..……………..…………………
……………………………..……………..…………………
……………………………..……………..…………………
……………………………..……………..…………………
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Continuity of the Fund Upon Death of the Donor
(An individual donor may request that the Foundation transfer the remaining assets of the Fund to a field-of-interest or
designated fund held by the Foundation at the time of the donor’s death. Alternatively, an individual donor may request that the
Foundation continue to administer the Fund after his or her death and may designate a spouse or domestic partner, or a child or
children as his or her successor(s) for purposes of exercising the privilege to recommend organizations or projects to be supported by
the Fund. Please note that such donor requests will not be honored if the principal of the Fund does not exceed the sum of
$100,000 at the time of the death of the donor.)

I request that, upon my death (or, in the case of a joint gift with my spouse or domestic partner, the later
of my death or his/her death), the Foundation transfer the remaining assets of the Fund to the
…………………………………….. Endowment Fund held by the Foundation.

I request that the Foundation continue to administer the Fund after my death (or, in the case of a joint
gift with my spouse or domestic partner, after the later of my death or his/her death). I designate the
following spouse, domestic partner, and/or child or children, as my (or our) successor(s) for purposes of
exercising the privilege to recommend organizations or projects to be supported by the Fund:
Name
Affiliation
Mailing Address
Phone
Email
……………………………..……………..…………………
……………………………..……………..…………………
……………………………..……………..…………………
……………………………..……………..…………………
……………………………..……………..…………………
Name
Affiliation
Mailing Address
Phone
Email
……………………………..……………..…………………
……………………………..……………..…………………
……………………………..……………..…………………
……………………………..……………..…………………
……………………………..……………..…………………
Name
Affiliation
Mailing Address
Phone
Email
……………………………..……………..…………………
……………………………..……………..…………………
……………………………..……………..…………………
……………………………..……………..…………………
……………………………..……………..…………………
Acknowledgement Options

Please recognize the name of this Donor-Advised Fund in all communications with the Fund’s grantees.

Please make all grants from this Donor-Advised Fund anonymously.
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Fees and Expenses
We understand that KBFUS will charge the following management fee for each grant made from the Fund:
- 5% of the first $100,000 of each grant to a nonprofit organization;
- 2% of the next $300,000; and
- 1% of the next $300,000; and
- 0.5% of the amount of each grant in excess of $700,000.
In addition, an annual investment fee is applicable for Donor-Advised Funds with invested assets, as follows:
- 1% of the Fund’s invested assets (0.25% assessed quarterly).
We also understand that any costs to the Foundation from accepting or transferring the amounts contributed
to the Foundation for the Fund shall be paid from the Fund.
Certification
We have received a copy of the Foundation’s ‘Procedures for Operation of Donor-Advised Funds’ and
understand that:
1.
The Fund shall be the property of the Foundation and shall not be deemed a separate trust fund held by it in a trustee
capacity. The Foundation shall have the ultimate authority and control over all property in the Fund, and the income
derived therefrom, for the charitable purposes of the Foundation. All grants to the Fund shall be irrevocable once accepted
by the Foundation.
2.
The Fund shall be used only for the charitable purposes of the Foundation as set forth in its organizational and governing
documents.
3.
The Foundation shall hold and administer the gift made with this letter and any subsequent contributions to the Fund
under the terms and conditions set out in this letter and subject to the terms and conditions set forth in the Foundation’s
governing instruments, including its articles of incorporation and bylaws, as amended from time to time and any applicable
resolutions of the Foundation’s Board of Directors. Except to the extent inconsistent with the terms and conditions set out
in this letter, the Fund shall be administered under the Procedures for Operation of Donor-Advised Funds approved by the
Foundation, including any amendments or additions to those Procedures made by the Foundation from time to time.
4.
Distributions from the Fund shall be made at such times, in such amounts, in such ways and for such purposes as the
Foundation shall determine. The Donor may submit to the Foundation recommendations with respect to distributions,
which recommendations shall be solely advisory, and the Foundation shall not be bound by such recommendations.
5.
In determining whether to make a distribution recommended by the Donor, the Foundation shall examine the following:
(a) the prospective recipient’s status as an organization described in Section 170(b)(1)(A) of the Internal Revenue Code of
1986, as amended (the “Code”) or the non-U.S. equivalent of a U.S. organization described in Section 170(b)(1)(A) of
the Code based upon the standards set out by the Internal Revenue Service in Revenue Procedure 92-94 (or any successor
guidance); (b) the prospective recipient’s willingness to cooperate with the Foundation’s exercise of expenditure responsibility
with respect to the distribution in accordance with Section 4945(h) of the Code; (c) the prospective recipient’s leadership,
reputation, and financial status; (d) the consistency of the project’s objectives with the Foundation’s exempt purposes; and
(e) the procedures for measuring achievement of the goals of the program to be funded by the proposed grant.
6.
Neither the Donor nor any advisor to the Donor nor any person related to the Donor or an advisor to the Donor may
receive, directly or indirectly, more than an incidental benefit as a result of a distribution from the Fund (such as a benefit
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7.
8.
9.
10.
11.
provided by the recipient of the distribution) and no distributions will be used to discharge or satisfy a legally enforceable
pledge or obligation of any person, including the Donor.
Neither the Donor nor any advisor to the Donor nor any person related to the Donor or an advisor to the Donor may
receive any grant, loan, compensation, or similar payment from the Fund.
In establishing the Fund or making recommendations with respect to distributions from the Fund, neither the Donor nor
any person related to the Donor (including, but not limited to, any of the Donor's directors, officers, employees,
representatives or other third parties acting on its behalf) or an advisor to the Donor, shall do so to pay, offer or promise to
pay, or authorize the payment of, directly or indirectly through any other person or entity, any monies or anything of value
to any person or firm employed by, or acting for or on behalf of, any government entity (including state-owned or controlled
entities or public international organizations), any political party or official of such party, or any candidate for political
office, for the purpose of inducing or rewarding favorable action (or the withholding of action) or the exercise of influence by
such person or firm, party or official, or candidate in any governmental matter or in any commercial transaction.
Nothing in this Agreement shall affect the status of the Foundation as an organization described in Section 501(c)(3) of
the Code and as an organization which is not a private foundation within the meaning of Section 509(a) of the Code.
This Agreement shall be interpreted to conform to the requirements of the foregoing provisions of the federal tax laws and
any regulations issued pursuant thereto. The Foundation is authorized to amend this Agreement to conform to the
provisions of any applicable law or government regulation in order to carry out the purposes of this Fund. References herein
to provisions of the Internal Revenue Code of 1986, as amended, shall be deemed references to the corresponding provisions
of any future Internal Revenue Code.
The Foundation and the Donor each reserve the right to terminate this agreement at any time, with an advance notice of
thirty days to be sent in writing to the other party. In the event that this agreement is terminated, the Donor may submit a
recommendation with respect to the use of any moneys held in the Fund on the date of the termination, which
recommendation shall be solely advisory, and the Foundation shall not be bound by such recommendation.
This agreement shall be governed by the internal laws of the State of Georgia.
Please indicate below your acceptance of this gift and of the terms and conditions noted above.
Very truly yours,
..........................................................................
(signature)
Name
Affiliation
Mailing Address
Phone
Email
……………………………..……………..…………………
……………………………..……………..…………………
……………………………..……………..…………………
……………………………..……………..…………………
……………………………..……………..…………………
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++++++++++++++++++++++++++++++++++++++++++++
ACCEPTANCE BY KING BAUDOUIN FOUNDATION UNITED STATES (KBFUS)
For acceptance of the gift and the terms and conditions described above:
………………………………………….
(signed by Jean Paul Warmoes, Executive Director, King Baudouin Foundation United States, Inc.)
………………………………………….
(date)
++++++++++++++++++++++++++++++++++++++++++++
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