How to Support the K AOHSIUNG M EDICAL U NIVERSITY F UND at Give2Asia This document outlines how donors in the United States and Canada, and overseas donors with U.S. or Canadian assets, may support Kaohsiung Medical University in Taiwan with tax-deductible contributions to the KMU Fund at Give2Asia. Background Give2Asia is a U.S. 501(c)(3) nonprofit organization, and Canada 149(1)(f) public foundation, founded by The Asia Foundation to promote charitable giving to Asia. Give2Asia offers donors a wide range of philanthropic services, allowing them to recommend specific organizations for funding, and providing expert research and advice on special giving opportunities in a given country or field of interest. All G2A grants are administered by its parent organization, The Asia Foundation, which maintains fifteen offices throughout Asia and has been a professional grantmaker since 1954. For more information, please visit www.give2asia.org. Give2Asia has formed a partnership with Kaohsiung Medical University (KMU) to provide administrative support for KMU’s U.S. and Canadian fundraising. Under this agreement, Give2Asia has established the restricted Kaohsiung Medical University Fund. Contributions made to the fund are reserved for use on KMU projects and are granted to KMU in Taiwan periodically. Notable aspects of the KMU Fund include: Gifts to the KMU Fund are tax deductible. Give2Asia is recognized as a tax exempt charitable organization in the United States (ID# 94-3373670) and Canada (Business number 85508 7045 RR0001). As such, donations are tax deductible according to U.S. and Canadian law. Please consult your financial advisor on structuring your giving for maximum tax benefit. You will receive a thank you letter and receipt in recognition of your gift. Upon receiving a gift, Give2Asia will issue a thank you letter and receipt recognizing the receipt of the gift to the KMU Fund. This letter may be used for tax reporting purposes. To support Kaohsiung Medical University through Give2Asia please complete the form on the opposite side. Give2Asia is honored to partner with Kaohsiung Medical University to provide a cost-effective solution for connecting with its U.S. supporters. For questions, please contact: Give2Asia- North American Headquarters Michael Rea, Managing Director 465 California Street, 9th Floor San Francisco, CA 94109 Tel: (415) 743-3336; Fax: (415) 392-8863 [email protected] Kaohsiung Medical University David C. Yang, M.D.,U.S. Liaison 221 Benedict Road Staten Island, NJ 10304 Tel: (718) 987-2872; Fax: (718) 667-5367 [email protected] GIFT TO THE KAOHSIUNG MEDICAL UNIVERSITY FUND Mail completed form to: In the U.S.: Give2Asia P.O. Box 193223 San Francisco, CA 94119-3223 (415) 743-3336 In Canada*: Give2Asia Suite 1555-15000 W. Georgia Street Vancouver, British Columbia, V6G 2Z6 I. DONOR INFORMATION Name ____________________________________________________________________________________________________ Chinese Name ______________________________________________ Date _____________________________________________________________________ Year of Graduation ______________________________________ School of ________________________________________________________________________ Street Address _____________________________________________________________________________________________ City, State, Zip, Country______________________________________________________________________________________ Day Telephone ___________________________________________ Evening Telephone ______________________________________________________________ Fax _______________________________________________________ Email ____________________________________________________________________________ II. DONATION DESIGNATION Please choose the project you would like to support General Fund [Unrestricted] University Construction Fund □ The 2nd Teaching & Research Building Fund □ Other Construction Fund Medical Research Fund □ Medical Research Fund □ Medical Research for Children Cancer Fund □ Medical Research for Cancer Fund Library Fund □ Books & Periodical [periodical name: _______________ ] □ Library Elevating Fund Academic Development Fund □ Academic Forum □ Development of Excellence in Teaching and Research □ General Education / Art and Literature Activity Kaohsiung Medical University Chung-Ho Memorial Hospital Teaching & Research Fund □ Specific: _______________ □ Hospital General Fund [Unrestricted] Kaohsiung Municipal Hsiao-kang Hospital Teaching & Research Fund □ Specific: _______________ □ Hospital General Fund [Unrestricted] Other (please specify) ______________________________ Agree to contribute the amount of □ 10% of donation to General Fund □ 20% of donation to General Fund III. CONTRIBUTION DESCRIPTION Check or Money Order $ ________________________ Please make check payable to Give2Asia and note KMU in the memo section. Online Credit Card Donation Please visit http://www.give2asia.org and click on KMU under Giving > Client Funds. Wire Transfer $ ________________________ Contact your bank or financial institution with the following information to initiate the wire transfer: PNC Bank N.A. 43 North Sixth Street, Stroudsburg, PA 18360 ABA # 031000053 (for U.S. wires) or Swift Code: PNCCUS33 (for international wires) Ref AC # 90-1175-2292 Give2Asia Please note KMU Fund so that it may be properly applied. Marketable Securities and/or Mutual Fund Shares Before transferring gifts of marketable securities, please complete the “Letter of Authorization for Securities Transfer” located in the Resource Center of www.give2asia.org. Please provide the following information to your broker to transfer the securities: Stern, Agee & Leach, clearing company for McKim Capital brokerage DTC # 0750 Account #: 73274436 Account Name: Give2Asia For all securities transfers, please indicate stock name and number of shares: Stock Name/Description Number of Shares ________________________________________ ____________________ ________________________________________ ____________________ Other: Please contact Give2Asia staff at (415) 743-3336 to discuss contributions of Restricted Stock, or other assets such as Real Estate. *Canadian donors wishing to receive a tax deduction should submit their contribution by check to the Canadian address listed above. Other methods of payment will not qualify for a Canadian tax deduction.
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