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Attachment A
TEXAS STATE TECHNICAL COLLEGE HARLINGEN
GIFT ACCEPTANCE AND TRANSMITTAL
A. DONOR INFORMATION
Name _________________________________________
Address _______________________________________
______________________________________________
Telephone numbers (H) _______________ (W)____________________
Email address _______________________________________________
Include in Donor List _______ Yes _______ No
If name(s) to be included is/are different from above please specify:
_________________________________
B. GIFT INFORMATION
Cash $ _________ Pledge $__________
_____ Credit Card _____ Visa _____ MasterCard
Acct # ______________________________
Exp. Date ___________________________
Name on card _______________________
Signature ___________________________
_____ Equipment/Supplies (please specify and use additional pages if necessary)
Description: _________________________________________
Donor value: ____________________
______Other (specify)
________________________________________________________________________
C. GIFT DESIGNATION
Cash/Pledges
_____ New account in The TSTC Regents Circle for purposes described in the
Account Agreement (Attachment B or C).
_____ Existing account in The TSTC Regents Circle for purposes described
in the existing Account Agreement.
_____ New account in the College/Business Office.
_____ Existing account in the College/Business Office.
Account name ___________________ New/Existing account number__________
Equipment and Supplies
_____ Donated to The TSTC Regents Circle for __________________________.
D. THIS FORM COMPLETED BY:
Name _______________________ Date _________
Location ____________________
TSTC –0-007 (08-02)
Attachment B
THE TSTC REGENTS CIRCLE
“Non-Endowed Account Agreement”
1. Name of Account: ______________________________________________.
2. The initial deposit delivered to The TSTC Regents Circle was $__________.
3. The purpose(s) of the account is/are:
______________________________________________________________________
4.Withdrawals from the fund will be made for the stated purpose(s) on written
request by the following TSTC Account Representative (or Alternate) to the System
Development Office.
PRIMARY
Name: _________________________________
Title: _________________________________
Address: _________________________________
Telephone: _________________________________
ALTERNATE
Name: __________________________________
Title: __________________________________
Address: __________________________________
Telephone: __________________________________
5.The TSTC Regents Circle will deposit the property of this account in a checking
or savings account (or other investment deemed appropriate by The TSTC Regents
Circle), but no interest, earnings, or appreciation shall accrue to the account.
6.If questions or problems arise concerning this account, the TSTC Account
Representative (or Alternate) is authorized to represent all donors to the fund
in determining what action is to be taken or in amending this agreement.
7.The TSTC Regents Circle Board of Directors has authorized the Executive Director
of The TSTC Regents Circle to be its agent in all matters relating to this fund.
8.The TSTC Regents Circle will provide account updates to The TSTC Regents
Circle Directors, the TSTC Account Representative, and/or the Donor or Donor
Representative, as appropriate.
9.The TSTC Regents Circle (and its agents) will have all the powers set forth
in Texas Code.
10. The TSTC Regents Circle will not be required to file any reports, appraisals,
inventories, or accounting with any court or to post bond.
DONOR OR DONOR REPRESENTATIVE
Name: __________________________________________
Organization/Company Name (if applicable): __________________
Address: ___________________________________________
___________________________________________
Telephone: ___________________________________________
Email ___________________________________________
Signature: ___________________________________________
Date: ___________________________________________
EXECUTIVE DIRECTOR
THE TSTC REGENTS CIRCLE
Signature: ___________________________________________
Date: ___________________________________________
ACCOUNT NUMBER
__________________________________________
COPIES
____ The TSTC Regents Circle
____ Donor or Donor Representative
____ President (if applicable)
____ Chancellor (if applicable)
____ Chair (if applicable)
Attachment C
THE TSTC REGENTS CIRCLE “Endowed Account Agreement”
1.Name of Account: _____________________________________________
2.The initial deposit delivered to The TSTC Regents Circle was $_________.
3.The purpose(s) of the account is/are: _______________________________________________________________
_______________________________________________________________
4.The parties intend that the corpus of this account will grow to a minimum
of $10,000 within five years. After five years, The TSTC Regents Circle will
maintain it as a perpetual (endowed) account for the purposes stated above,
as long as the account maintains a minimum balance of $10,000.
5.The parties agree that if the corpus does not reach the minimum level within
the minimum time frame, The TSTC Regents Circle will contact the Donor or Donor
Representative for direction as to the handling of the cash reserve.
6.If at any time, the appropriate Resource Development Officer and the Donor
or Donor Representative determine that there is no longer a need for this account
for the purpose(s) noted above, then the parties agree that the distributions
will be made for any purpose benefiting the following unit or for another stipulated
purpose: _____________________________________.
7.Requests for distributions may be initiated by ________(title of college
or System officer), although this is not required unless specified in section
3.
8.All available dollars will be distributed annually for the purposes specified
above and in accordance with The TSTC Regents Circle financial management policies.
9.If the TSTC Regents Circle has any questions, the Donor or Donor Representative
will be contacted. In their absence, the Donor authorizes The TSTC Regents Circle
to consult with ______________________________.
10.The TSTC Regents Circle will provide Account Updates to The TSTC Regents
Circle Board of Directors, the TSTC Harlingen Account Representative, the Donor,
and/or the Donor Representative, as appropriate.
11.The TSTC Regents Circle and its agents have all powers set forth in Texas
Code.
12.The TSTC Regents Circle will not be required to file any reports, appraisals,
inventories, or accounting with any court or to post bond.
DONOR OR DONOR REPRESENTATIVE
Name: _______________________________________________
Organization/Company Name (if applicable): _______________________
Address: ________________________________________________
________________________________________________
Telephone: ________________________________________________
Email: ________________________________________________
Signature: ________________________________________________
Date: ________________________________________________
EXECUTIVE DIRECTOR
THE TSTC REGENTS CIRCLE
Signature: ________________________________________________
Date: ________________________________________________
ACCOUNT NUMBER:
___________________________
COPIES:
_____ The TSTC Regents Circle
_____ Donor or Donor Representative
_____ Chancellor (if applicable)
_____ President (if applicable)
_____ Chair (if applicable)
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