Granting Recommendation Form

I/We recommend that the Board of Directors of the Community Foundation of Johnson County, Iowa award the following grant(s):
Name of Fund*
As an advisor to the named fund, I recommend that the Board of Directors of the Community Foundation of Johnson County, Iowa consider the following grant to the nonprofit organization specified for the purpose described below.
Grant Amount*
Organization Name*
Organization Address
Street Address City State ZIP Code
Grant Purpose*
Organization Tax ID:
I certify that the above recommendation does not represent the payment of any irrevocable or legally binding pledge or other financial obligation, nor does the undersigned, any family member adviser or any other related party expect any personal benefit from this grant expenditure. I also acknowledge the above recommendation is subject to approval of the Board of Directors of the Community Foundation of Johnson County, Iowa.*
I certify that the above recommendation does not represent the payment of any irrevocable or legally binding pledge or other financial obligation, nor does the undersigned, any family member adviser or any other related party expect any personal benefit from this grant expenditure. I also acknowledge the above recommendation is subject to approval of the Board of Directors of the Community Foundation of Johnson County, Iowa.
I have read the granting statement.
I certify that by typing my name in the form below, I am hereby electronically signing this form. This electronic signature is the legally binding equivalent to my handwritten signature.*
I certify that by typing my name in the form below, I am hereby electronically signing this form. This electronic signature is the legally binding equivalent to my handwritten signature.
I acknowledge my e-signature as equivalent to my handwritten signature.
Name
First Last
Date
MM slash DD slash YYYY

If you prefer to print and fill out the Grant Recommendation Form, please send the completed document to Shirley Fliehler at the Community Foundation of Johnson County.

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