Sample Letter Of Instruction From Donor To Ira Provider

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Sample Letter of Instruction from Donor to IRA Provider
[DATE]
[NAME OF IRA PROVIDER]
[ADDRESS]
[CITY, STATE, ZIP]
(Call your plan provider to determine the most efficient way to send this letter of instruction)
Re:
Request for Qualified Charitable Distribution from Individual Retirement Account
Dear Sir or Madam:
Please accept this letter as my request to make a qualified charitable contribution from my Individual
Retirement Account Number:
[insert account number]
as provided by the Tax Increase Prevention Act of 2015 and Sec. 408(d)(8) of the Internal Revenue Code of
1986, as amended.
Please issue a check in the amount of $____________ payable to Project SHARE at the following
address:
Project SHARE
5 North Orange St., Suite #4
Carlisle, PA 17013
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 20XX tax year. Therefore, it is imperative that this distribution be postmarked no later
than December 31, 20XX.
If you have any questions or concerns regarding this request, I can be reached at [PHONE AND EMAIL
ADDRESSES].
Thank you for your prompt attention to and assistance with this matter.
Sincerely yours,
[DONOR NAME]

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