Phone: Business Phone: Email Address: Cell Phone: Fax: Date of Birth (mm/dd/YYY): 4. ALLOW 4 WEEKS FOR DONOR(S) TO PROVIDE ALL INFORMATION DETAILS! 3. DONOR(S) WILL APPLY AT A HEALTHCARE PRIMARY CARE DOCTOR (or DDS) IN MARYLAND (if in state, please apply in your city). DONOR(S) WILL HAVE A MINIMUM OF 30 MINIMUM HOURS OF RECEIVING VACCINE DOSE IN MARYLAND. APPLICATION DEADLINE IS NOW NOVEMBER 30, 2017 4/16/2018 10:51:24 AM.
1501991 JOHN H. MALONE, MD HEARING OFFICER I N/A 500,001 – 1,000,000 None (or less than 201)
1501982 TONY PELOSI, MD HEARING OFFICER N/A 100,001 – 250,000 None (or less than 201)
1501983 JOHN M. SMITH, MD N/A None (or less than 1,001) Charitable organization (firms, foundations, etc)
1501986 ANTOINE A. McBride, MD, MDF DEFACE Doctors in practice for over 30 years
1501824 GILBERT LEONARD DURAND, MD (Podiatrist)
1501825 JOSEPH R. LEONARD DURAND, MD (Pediatrician)
1501963 ROBERT N. WALLACE, MD, MDC, FAF PALACE, FLAP Doctors in practice for over 37 years
1501564 DONALD G. VELASCO, DO (D.O.B. 9-27-1954), F/M Doctors in practice for more than 23 years
1501565 JEFFREY M. GARCIA, MD (Pediatrician / Surgeon), PULITZER FACULTY, SANTA MARIA, CA (Pediatrician / Pediatrics)
1501962 ERIC L. BORDEAUX, DO (P.C.
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DONOR ADVISED FUND APPLICATION (Please Print) 1. SELECT DONOR(S) Donor #1 Mr. Mrs. Name (First, Middle, Last): Ms. Miss Dr. Other: Nickname (If applicable): Mailing Address City, State, Zip Code Employer:
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What is donor advised fund application?
A donor advised fund application is a formal request submitted by an individual or organization to establish a donor advised fund with a charitable organization. This application typically includes personal and financial information about the donor, as well as details about the intended use of the funds.
Who is required to file donor advised fund application?
Individuals or organizations who wish to establish a donor advised fund with a charitable organization are required to file a donor advised fund application. This includes individuals seeking to create a personal donor advised fund as well as corporations or foundations looking to establish a separate fund for their charitable giving.
How to fill out donor advised fund application?
To fill out a donor advised fund application, you typically need to provide personal information such as your name, address, and contact details. You may also be required to provide financial information, including details about your source of funds and your intended contribution amount. Additionally, you may need to describe how you plan to recommend grants from your donor advised fund and any specific charitable goals or areas of interest you have.
What is the purpose of donor advised fund application?
The purpose of a donor advised fund application is to establish a formal agreement between the donor and the charitable organization administering the fund. This application helps ensure transparency, clarity, and accountability in the management of the funds and allows the donor to specify their charitable intent and preferences for grant recommendations.
What information must be reported on donor advised fund application?
The exact information required on a donor advised fund application may vary depending on the charitable organization and local regulations. However, common information reported includes personal details of the donor, such as name, address, and contact information, as well as financial information, including the source and amount of funds being contributed. Additionally, the application may ask for details about the donor's philanthropic goals and preferences for grant recommendations.
When is the deadline to file donor advised fund application in 2023?
The deadline to file a donor advised fund application in 2023 may vary depending on the charitable organization and local regulations. It is recommended to contact the specific organization or consult their website for the exact deadline.
What is the penalty for the late filing of donor advised fund application?
The penalty for the late filing of a donor advised fund application may vary depending on the charitable organization and local regulations. It is recommended to consult the specific organization or seek professional advice to understand any potential penalties or consequences for late filing.
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