IRA QUALIFIED CHARITABLE DISTRIBUTION (QCD) FORM IRA QCDs or IRA Charitable Rollovers, as they are sometimes called, are an increasingly popular way for donors 70 ½ or older to support the lifesaving work of the Center for Urban Familes. You can make up to $100,000 in tax-free charitable distributions annually, lowering your taxable income, and, if you’re age 72 or older, helping you to meet your minimum distribution requirement or RMD. To initiate a qualified charitable distribution from your IRA to the Center for Urban Families, your IRA trustee will need the following information: Legal name:
Center for Urban Families
Taxpayer ID:
52-2142708
Permanent address: 2201 North Monroe Street Baltimore, MD 21216 It is my intention that this charitable rollover gift comply with the IRS Qualified Charitable Distribution requirements. Accordingly, when the Center for Urban Families receives the QCD gift from my financial institution, it will provide me with a written acknowledgment of the gift date and amount, stating no goods or services were transferred to me in consideration for the gift. In your transmittal to the Center for Urban Families, please indicate my name and address as the donor of record and copy me on your correspondence on connection with this transfer. It is my intention to have qualify for exclusion during this tax year. Donor’s signature: ___________________________________________________________ Date: ___________ Printed Name: ______________________________________________________________________________ Address: ___________________________________________________________________________________ City: ____________________________________________________ State: ___________ Zip: ______________ Phone:_____________________________________________________________________________________ Email: _____________________________________________________________________________________ IRA gift amount: $ ___________________________________________________________________________ Name of IRA financial institution: _______________________________________________________________
Please return this form to your IRA trustee and instruct him or her to send the form and your IRA charitable rollover gift to: Center for Urban Families Attn: IRA QCD 2201 North Monroe Street Baltimore, MD 21216
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