c3 status as a charitable organization each year While your official IRS 501c3 form is not needed at this time we need the information below This form needs to be completed signedand returnedto our of ID: 895290
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1 Birdies for Charity requires all partici
Birdies for Charity requires all participating organizations to verify their 501 (c) 3 status as a charitable organization each year. While your official IRS 501 (c) 3 form is not needed at this time, we need the information below. This form needs to be completed, signed, and returned to our office before you will be able to participate in the 20 21 Birdies for Charity program and receive a check. Money collected by Bi rdies for Charity for organizations without 501(c)3 verification will be applied to the Bonus Fund to benefit ALL participating, qualified 501(c)3 organizations . Charity Name: _ ______________________________________________________ _ Bird # * ________ _________ EIN # ______________________ * If you do not know your Bird #, please see the Charity List at www.birdiesforcharity.com . Brief description or purpose of organization (1 - 2 sentences): _ ______________________________________________________ _ _ _________________________________ _____________________ _ _ ______________________________________________________ _ Contact Information: This is where we will send ALL correspondence and checks. If any of the information you provide below change after submission of this form, please notify the Birdies for Charity office. C HECK HERE IF CONTACT INFORMATION HAS CHANGED WITHIN THE PAST YEAR Contact Person :_____________________________________________ _______ _______ ______ Email address : ___________________________ Contact Phone:__________________________ Address: _ ______ This form certifies that _________________________________________________ (charity name) is still a valid 501(c)3 charitable organization as reflected in the original submission to the Birdies for Charity program. This form also certifies that the charity agrees to comply with the rules and regulations of the Birdies for Charity program as stated in the official program rules . The Birdies for Charity program is intended to support charitable organizations, services, operations, and programs. It is not intended to be used for endowment or brick and mortar charitable purposes. Charitable This form also certifies that the charity has review ed and understands the cu rrent year ’ s Charity Reference G u ide , including important update s effective 2021 . _____ _______________________________________ ________________ Signature Date ____________________________________________ Title with Organization Birdies for Charity Attn: M icaela Booth 15623 Coaltown Road Please complete , sign & East M o line , IL 612 44 return by May 22, 2021 Phone: (309) 762 - 4653 Fax : (30 9) 762 - 4668 micaelab@j d cla ssic.co m 20 21 Birdies for Charity 501(c) 3 Verification Form