Date:
 
Jacksonville Jewish Foundation
P.O. Box 24847
Jacksonville, Florida 32241
Fax your order to:
904-394-0956 download
form, click here
 
Pursuant to the terms of the
which I/we have
 
Name of Donor Advised Fund
  
established at the Jacksonville Jewish Foundation, I/we hereby recommend that you disburse from the
Fund the following amount/s to the named charitable organization/s:
 
Name of Organization: Amount:
Address:
   
Special Instructions:
Name of Organization: Amount:
Address:
   
Special Instructions:
Name of Organization: Amount:
Address:
Special Instructions:

 
Authorized Signature   Authorized Signature
     

PLEASE NOTE: Donor acknowledges that the above suggested distribution does not represent the payment of any legally enforceable pledge or other financial obligation. Donor further acknowledges that he/she has not received nor will he/she or other related parties receive goods or services in return for this/these contribution/s.

PHONE: 904-394-0720 - FAX: 904-394-0956 - www.JacksonvilleJewishFoundation.org