Of the National Capital Area

COMBINED FEDERAL CAMPAIGN OF THE NATIONAL CAPITAL AREA 2014 APPLICATION CHECKLIST for UWCM Federation Member Agencies Deadline – 4:00 p.m. November 12, 2013

o Completed and signed application. Please do NOT use staples for any of your documents. Binder and paper clips are acceptable. o Attachment A certifying local, adjacent, or statewide presence, describing services, including location of facilities and hours of operation. NOTE: Follow new OPM guidelines for preparing this. Statements from prior years are not sufficient. o Attachment B a copy of your IRS determination letter, including Employer Identification Number (EIN) o If IRS letter is a group exemption, include a letter from the CEO of the group verifying your organization’s bona-fide chapter status and financial reporting. o If using something other than a legal name, DBA paperwork in your home state or jurisdiction is required. o Verify that your EIN is valid (not expired) and that it is in the IRS database or Publication 78. o Attachment C a copy of audited annual financial statements REQUIRED for organizations with $250,000 or more in revenue for a period ended not more than 18 months prior to January 2014 (e.g., ending on or after 6/30/12). o Attachment D a copy of a complete signed IRS Form 990 for a period ended not more than 18 months prior to January 2014 (e.g., 6/30/12). MUST be the SAME period covered in the audit. o Attachment E a 25-word statement for listing in the campaign brochure and optional taxonomy codes. o Signatures on application form. o All certifications checked appropriately. o 2 copies of all attachments, 1 ORIGINAL signed application and 1 COPY of the signed application. o Email the completed Excel spreadsheet ONLY to [email protected] with the subject line [your agency name – NCACFC Spreadsheet]

PLEASE MAIL THE COMPLETE APPLICATION PACKAGE USING A MAIL SERVICE THAT TRACKS DELIVERY WITH SIGNATURE TO:

Attention: Liz Acosta (2014 NCACFC Federation) United Way of Central Maryland 100 South Charles Street, 5th Floor Baltimore, MD 21201 **You are welcome to mail your Chesapeake Bay and National Capital Area application packets in the same mailing if applying to both. Please label your application packets with a cover sheet that specifies the CFC to which you are applying.**