CHARITABLE INTEREST WORKSHEET

Optional - Send this with your application or prepare at your convenience This form will serve as a general recommendation to The American Foundation™ regarding the  charitable  objectives  of  your  family  foundation.   This   will  be  helpful  if,  for  some unforeseen   reason,   your   selected   charitable  grant   advisor  does  not  submit   annual recommendations   for   charitable  grants. If  no  advisors   are  selected,  The   American Foundation will refer to this sheet in making future charitable grants in your name. Personal involvement in charity and "donor advised" funds is highly encouraged. In fact, we believe   the  more  and  longer  a  donor is  involved, the better.  Three good things usually happen  when  individuals,  families  and  business  leaders  become  more  involved in the charitable process: 1. More charitable funds are developed; 2. Contributors become better people; and more often than not 3. The charitable activity or program itself will be more effective and successful. We attribute this phenomenon to a term we call "charitable ownership". The American Foundation would like to  help you create  and develop a clear definition of your charitable interests. This form can help you develop an individual or family charitable mission  statement.  We  welcome,  at any time, letters  of recommendation regarding any creative  arrangement  you  might design for the ongoing charitable involvement of family members, friends, and heirs.
1.	Please establish a mission statement that your heirs or others can look to for guidance.
	Determining Your Charitable Mission
	Example: Our mission is to build family unity through charitable giving.
	Do you have general fields of interest you and your family want to support?
2.	General Fields of Interest
	Example: Animal Welfare
Are there specific charities you want to support?
3.	Determining your Charitable Mission
4.	Fixed Recommendations:
	The following represent four options for determining how future charitable grants will be handled.  Please initial  the box next to  the option that best  reflects your wishes.   If desired, you may also  give us a separate written instruction containing your special wishes and desires regarding grants from your foundation account.
		Your selected successor charitable advisor will make all charitable grant recommendations. (If you select this box, you do not need to fill out the following table.)
		You designate a fixed portion (dollar amount or percentage) of annual income and/or growth to go to specified  charities or  charitable fields of interest, with the balance to be distributed by   your successor charitable advisor.  (Please fill out the table below.)
		You designate the total fixed dollar amount or percentage  of annual  income and/or growth to go to your charitable fields of interest. (Please fill out the table below.)
		You designate the total  fixed dollar amount  or percentage of annual income and/or growth to go to specified charities.  (Please fill out the table below.)

Specific Charity or Charitable Field of Interest	Dollar Amount or Percentage of Income
Additional gift allocation to the American Foundation (over and above the annual 1% described in the Program Description)

Note:

Grant recommendations can be made up to the maximum amount of 100% of the annual income or growth of your family foundation. If the dollar amounts of your grant recommendations exceed 100% of the annual income and growth of your family foundation, the American Foundation will notify you so that adjustments can be made.

5.	Donor Signature (s)
	Donor 1 Signature	Date:
	Donor 2 Signature	Date:

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