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Sample Request from Plan Owner to IRA Administrator for 2017 Charitable Distribution


[Donor Name]
[Donor Address]


______________________, 2017



[Name of IRA Administrator]
[IRA Administrator Address]

RE:  Request for Charitable Distribution from IRA

Dear Sir or Madam:

Please accept this letter as my request to make a direct charitable distribution from my Individual Retirement Account # ______________________ as provided in The Protecting Americans from Tax Hikes Act of 2015 and Section 408(d)(8) of the Internal Revenue Code of 1986, as amended.

Please issue a check in the amount of $___________ payable to Stanford University and mail it to:

Stanford University
Development Services
P.O. Box 20466
Stanford, CA 94309-0466

Stanford University’s tax identification number is 94-1156365.

In your transmittal to Stanford, please include my name and address as the donor of record in connection with this distribution. Please copy me on your transmittal.

It is my intention that this distribution qualify for exclusion from my taxable income during the 2017 tax year. Therefore, it is imperative that this distribution be delivered to Stanford no later than December 31, 2017.

If you have any questions or need to contact me, I can be reached at ________________.

Thank you for your assistance in this matter.

Sincerely,

____________________________

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