Campaign Report Envelope Form - State Of Virginia
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1Envelope Type
? WP ? A/R ? Misc. ? Adj. ? Gift in Kind ? Grant
For United Way Use Only
Campaign Report Envelope
United Way of the National Capital Area
IMPORTANT INSTRUCTIONS
1577 Spring Hill Road, Suite 420
Vienna, VA 22182-3819
ENCLOSE IN THIS ENVELOPE: Fully paid contributions, checks and credit card requests.
United Way copy of all pledge forms. Your company’s/organization’s pledge/
designation forms (if United Way pledge forms are not used).
NOTE:
Interim, partial reports enable the United Way Campaign
DO NOT ENCLOSE IN THIS ENVELOPE: Cash in any form (paper or coins).
to help you keep records and track campaign progress.
FORWARDING INFORMATION:
Standard Envelopes:
Mail or Deliver Signed, Sealed Envelopes Directly To:
United Way of the National Capital Area
Campaign Accountability
ACCOUNT NUMBER:
1577 Spring Hill Road, Suite 420
Vienna, VA 22182-3819
COMPANY / ORGANIZATION:
Questions:
Please cross out any incorrect company / address information on the line.
All information on this report should reconcile with your Pledge Forms.
ADDRESS:
Please enclose Pledge Forms for accounting purposes, all pledge forms must be
enclosed.
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?
?
PARTIAL REPORT
FINAL REPORT
ADDITIONAL REPORT
# OF GIVERS
PLEDGES/PAYMENTS $
ENCLOSED PAYMENTS $
PAYROLL CONTRIBUTION
Triplicate Forms: Send yellow copy of pledge
form to United Way. Send white copy to YOUR
payroll department. Non-Triplicate Forms:
Send original copy of pledge form to United
Way. Send copy to YOUR payroll department.
Checks, credit card charges, direct bill. Please
PAPER CLIP checks to pledge cards.
Please enclose Corporate Pledge Card or
CORPORATE GIFT
Corporate Grant.
Please enclose supporting documentation.
GIFT IN KIND
Make checks payable to United Way.
SPECIAL EVENTS
TOTALS
Date: _____________________________________________________________
Total # of Employees in Organization:
ECC (Employee Campaign Coordinator) Information:
Preparer’s Signature:________________________________________________
Name: ____________________________________________________________
Preparer’s Name: ___________________________________________________
Phone: ____________________________________________________________
Preparer’s Phone: __________________________________________________
Email: ____________________________________________________________
Preparer’s Email: ___________________________________________________
FOR UNITED WAY USE ONLY
CASHIER / DATE
AUDITOR / DATE
DATA ENTRY / DATE
PROOFER / DATE
CLOSED / DATE
PLEASE MAKE A COPY FOR YOUR RECORDS
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