TA Winter Grant Proposal August 9 2017

REQUEST FOR GRANT

AEGON TRANSAMERICA FOUNDATION

Name of Applicant:

Address and Phone Number:

Title of Project:

Purpose of Project:

Period for which support is requested (total project period):

From

To

(Month, Year)

Month, Year)

Total Project Budget: $7,000.00

Name, title, address and phone number of person ultimately responsible for the project for which funds are being sought:

Applicant’s tax-exempt status:

Before the Foundation can take action on your proposal, we need evidence that your organization is currently a tax-exempt entity, as described in Section 501(c)(3) of the Internal Revenue Code, and is not a private foundation described in Section 509(a). To satisfy this requirement, please provide a copy of the Internal Revenue Service favorable determination letter on your tax-exempt status. Unified Efforts, Inc. is a program of Fusion Partnerships, Inc. a nonprofit 501 (c) (3) organization by which all donations are tax deductible: See attached documents.

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