Sample Letter to Plan Provider

Sample Letter to Plan Provider

Name of Plan Provider
Address
City, State Zip

Re: Request for Direct Charitable Distribution from Individual Retirement Account

Dear Sir or Madam:

Please accept this letter as my request to make a direct charitable contribution from my Individual Retirement Account Number:

[insert account number]

as provided by the Tax Relief, Unemployment Insurance Reauthorization and Job Creation Act of 2010 and Sec. 408(d)(8) of the Internal Revenue Code of 1986, as amended.

1. Please issue a check in the amount of $____________ payable to the Girl Scout Council of the Nation's Capital (Federal Tax ID# 54-0732-966) at the following address:

   GSCNC, M-2; 4301 Connecticut Ave, Washington, DC, 20008

   In your transmittal to the charity, please state my name and address as the donor of record in connection with this transfer, and copy me on your transmittal.

   It is my intention to have this transfer qualify during the 2011 tax year. Therefore, it is imperative that this distribution be postmarked no later than December 31, 2011.

- OR -

1. Please issue a check in the amount of $____________ payable to Girl Scout Council of the Nation's Capital and send the check directly to me at my address of record.

If you have any questions or concerns regarding this request, I can be reached at (telephone and email address).

Thank you for your prompt attention to and assistance with this matter.

Sincerely yours,

Name of Donor