Grant Application – Masonic Foundation of Utah

Organization Name

Type of Organization or Entity

Organization History and Purpose

Applicant/Contact Name

First

Last

Address

Address Line 1

Address Line 2

City

State

Zip Code

Applicant Email Address

Applicant Phone

Taxpayer Identification Number

Charitable Contributions

Yes
No

Have you received a favorable determination letter from the Internal Revenue Service stating contributions to you are deductible as charitable contributions?

Upload a copy of your 501(c)(3) determination letter.

Drag & Drop Files, Choose Files to Upload

Grant Amount Requested

Contributions to the Foundation

Yes
No

Are the spending policies of your organization controlled or influenced by one who has or whose family has contributed more than $5,000 to the Foundation?

If yes, please explain.

Spending Policies

Yes
No

Are the spending policies of your organization controlled or influenced by any member of the Board of Trustees of the Foundation or their families? Board: Ridgely H. Gilmour Frank C. Baker John C. Liley, Jr. Daniel J Lawes Presiding Most Worshipful Grand Master

If yes, please explain

Upload copy please

Authorization

I certify that to the best of my knowledge the information contained in this application is correct and complete.