Democracy Funders Network Income Notification

Contina Impact

Please fill out this form to notify our finance team of an incoming donation or grant to support this project.

If you are a human, ignore this field

Fields marked * (Required) must be completed; ~ Optional fields are optional.

Contribution Details

Donation Date * (Required)

Amount * (Required)

Donation Purpose

In a few words, tell us what this contribution supports (e.g., a specific program, fund, or campaign).

Send Invoice * (Required)

If you would like to receive an invoice from our finance team to pay through your financial institution, please click yes. Note: Unless specifically requested, most payments from DAFs do not require an invoice.

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Donor Information

Donor Name * (Required)

Please list the primary donor name, either an individual or entity.

DAF Name ~ Optional

If the entity is a Donor Advised Fund, list the name of the specific DAF here.

This is an anonymous donation

Contact Information

This is the contact who will receive any correspondence or acknowledgement related to the contribution.

Contact information is required for our internal records and is not reused, sold, or otherwise distributed or publicly disclosed except where required by law. Your submission will be cancelled without this information.

Contact First Name ~ Optional

Contact Last Name ~ Optional

If there is a contact person, please list them here.

Phone Number * (Required)

Email * (Required)

Address 1 * (Required)

Address 2 ~ Optional

City * (Required)

State * (Required)

Zip * (Required)

Contribution Acknowledgement

Please indicate below whether your contribution is Unrestricted (General Purpose) or Restricted to a specific purpose or project fund.

Unrestricted Gift. By checking this box, you confirm that you are making this contribution voluntarily. You acknowledge that this contribution is an unrestricted gift and that you do not expect any goods, services, or other benefits in return. Restricted Gift. By checking this box, you confirm that you are making this contribution voluntarily. As described in the attached grant award letter, contribution letter, or other legal document, this gift is restricted or conditional. Contina Impact staff will review this gift for any legal conditions, right of return, benefits or restrictions.

Additional Information

Attachments

Please upload up to 5 files to support your donation, such as award letters, grant agreements, DAF contribution recommendations, wire transfer instructions, etc. If your donation is restricted or has a benefit attached, you are required to attach files in support of the restriction.

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Additional Notes ~ Optional

Is there anything else you'd like us to know about this donation?