2016 annual report

Our Core Leadership Dear Valley County Friends, nity members of all ages now and into the My work often takes me to the Valley future. The wonderful power of the unreCounty Courthouse. As I walk by the stricted endowment allows the funds dostone inset in the sidewalk outside the nated today to generate income courthouse that reads, "Virtue Has indefinitely so we are able to benefit our Developed A Valley", I often reflect on county today, and also for generations to the hope and optimism of the early come. Through the use of endowments, pioneers who “It is so exciting to think that no matter what the VCCFF is first settled this able to create a area. They were the future may bring, there will be funds responsible and surely met with available to continue to empower and engage s u s t a i n a b l e challenges, but our youth, to bring alumni back to our home- method of clearly, they were towns, to grow and enhance our leadership funding to meet also grateful for capacity, and to continue to create a vibrant the needs of the blessings culture where our families can grow and our county. In Valley County thrive.” the following provides. That Heidi Proskocil, VCCFF Chairman pages, you’ll hope and gratisee just a samtude continues to thrive in our county- pling of the ways VCCFF is making imwide community today, and the Valley pacts throughout Valley County with the County Community Foundation Fund use of endowment funds. It is so exciting is working to ensure it continues for to think that no matter what the future may years to come. The bring, there will be funds available to conVCCFF unrestricted tinue to empower and engage our youth, endowment gives to bring alumni back to our hometowns, us the oppor- to grow and enhance our leadership capactunity to en- ity, and to continue to create a vibrant culrich the lives ture where our families can grow and of commu- thrive. With each contribution to the unre-

stricted endowment, we are investing in the present and giving back to the future.

We are creating a mindset of hopeful, joyful abundance. We are not simply leaving a legacy – we are creating a legacy. Won’t you join us?

Respectfully,

Heidi Proskocil VCCFF Chairman

The Fund Advisory Committee is made up of Valley County residents who provide oversight for endowment accounts and other subaccounts and make grant decisions.

Fund Advisory Committee members are diverse in age, occupations, expertise and perspectives. Members collaborate with varying views with a common interest-the greater good of Valley County.

Heidi Proskocil - Chairman Darlene Psota - Vice Chairman Jodi Sell - Secretary Jennifer Plate - Treasurer Bob Stowell - Past Chairman Dahn Hagge - Coordinator Bryant Els Christina Pollard Duane Psota

Ray Scott Jean Stowell Joe Wadas Harry Walahoski Dale Zadina Carrie Zangger Chuck Zangger Kevin Kreger

A special thank you to our retiring members for serving on the VCCFF, including - Logan Plate, Bryant Foth, Larry Schultz and Janie Zadina.

Our Heart & Soul

“I believe the heart and soul of the VCCFF Formed in 1999, the VCCFF is dedicated to investing in a vibrant future can be summed up in one word: PEOPLE. for the people of our county-wide community by: We acknowledge that the life we are • Building local endowments, (permanent community savings accounts) to ensure financial resources are available to meet our current needs privileged to live today here in Valley County and pursue future opportunities is the result of the sacrifice of others who came before us. They are our foundation. • Connecting through progressive partnerships We embrace the unique gifts and talents of • Empowering and engaging youth through educational opportunities others who work and plan with us on a daily • Attracting alumni and new people to our hometowns basis. They are our inspiration. We celebrate • Enhancing leadership capacity..fostering entrepreneurship the future of others who will come after us, development…and nurturing a culture of giving as they are our passion.”

Darlene Psota, VCCFF Vice Chairman

We Love Valley County Elyria

Arcadia

Ord

North Loup

Opportunity Of A Lifetime

The Endowment Campaign Challenge

In 2013, the Valley County Community Foundation Fund Advisory Committee members learned of The Sherwood Foundation and Nebraska Community Foundation initiative to increase the unrestricted endowment funds and build leadership capacity. To qualify for The Sherwood Foundation challenge grant, committee members participated in a competitive application process along with 15 other communities. Valley County Community Foundation Fund was one of only four selected.

Now, the VCCFF is on a journey to build the unrestricted endowment and achieve the incredible grant challenge to ensure powerful resources are available to continue building community vitality for generations to come!

The goal of the campaign is to raise

$500,000 in unrestricted endowment funds. Once this goal is achieved, The Sherwood Foundation will grant the VCCFF an additional $250,000. The immediate impact of additional $750,000 in the unrestricted endowment will bring a significant increase in annual grants to improve and enhance our county-wide community. The campaign also honors the place where we raise our children build our businesses and achieve our dreams!

A great benefit of the Unrestricted Endowment for Valley County’s future is that under current financial conditions, a gift of $100,000.00 to the

Unrestricted Endowment will, in twenty years, result in growth of the Unrestricted Endowment to $180,000.00, even after having paid out $120,000.00 of earnings in cumulative grants for worthy causes such as: youth engagement, leadership development, entrepreneurial endeavors, arts and cultural experiences, community infrastructure and newcomer attraction, to name a few.

For every $2.00 donated in unrestricted gifts to the permanent endowment by December 31, 2018, The Sherwood Foundation will grant $1.00 in unrestricted funds to the permanent endowment, up to a maximum of $250,000.

The Power of Endowment Endowment Balance

Cumulative Grantmaking Over Time

$2m C

$1.8m $1.6m $1.4m $1.2m $1m $800k $600k $400k $200k Beginning Balance

After 10 years

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After 15 years

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The Value of Endowments

Gifts to an endowment not only last forever, they increase in size. The principal of the endowment will remain intact forever, while VCCFF grants earnings from investment returns to support worthy projects throughout Valley County. As one Fund donor describes it, “Giving to the unrestricted endowment is like contributing to an insurance policy for the future of our community.”

A strong unrestricted endowment means many things for Valley County.

No one can predict with certainty the needs or opportunities that present themselves in the future. By contributing to the endowment, a donor will help the community address pressing issues as they arise and capitalize on opportunities for community growth and improvement as they occur.

This provides unlimited possibilities for future generations.

As an affiliated fund of the Nebraska Community Foundation (NCF), which serves 251 communities in 79 counties, Valley County Community Foundation Fund receives financial management, strategic development and education services. Affiliation with NCF provides advantages in both safekeeping and independent auditing of of endowment accounts and all sub-accounts.

As community leaders – embodying philanthropy with both dollars and time – each member of the Fund Advisory Committee has pledged a contribution to this endowment campaign totaling over $200,000. By contributing to a fund with strong leadership and broadly defined community goals and sound financial management; a donor can have confidence that the future of our county-wide community will be well served by the Valley County Community Foundation Fund for decades to come.

“There’s no time like now to contribute!”

Larry Schultz, retired VCCFF Advisory Committee Member

The Time is Now

The unrestricted endowment is a powerful, permanent legacy. It will have a lasting impact in our hometowns beyond current generations. Growing the unrestricted endowment now and allowing it to build over time will help our citizens prepare for the future with confidence.

With robust permanent endowments, the possibilities are endless.

The Sherwood Foundation has put forward a generous challenge grant of $250,000. We cannot miss this opportunity to build a permanent endowment.

Now is the time.

Your investment in this campaign will ensure Valley County is a great place to call home and a vibrant rural leader in Nebraska for decades to come!

Together we hold the future in our hands as we create this powerful legacy!

Nebraska Community Foundation (NCF) serves communities, organizations and donors throughout Nebraska with a range of services, including financial management, strategic development, education, training and peer learning for affiliated funds statewide. NCF works to build relationships with community leaders, donors and their financial advisors to help them achieve the impacts that charitable giving can have on community economic development outcomes. NCF encourages community leaders to build on this ethic to use charitable giving to address the current and future opportunities that make rural communities better places to live and work. By building permanent community assets, NCF reaches out to help everyone deepen or rekindle their belief in the future of their hometown.

Susan A. Buffet established The Sherwood Foundation in 1999. Reflecting her deep hometown roots and belief in social justice, the foundation focuses on racial and social equity initiatives in Omaha, particularly early childhood education, public education and poverty alleviation. In recent years, The Sherwood Foundation has broadened its efforts to partner with communities across the state of Nebraska. The intent is to help community members strengthen the places they call home, build local capacity and deepen participation in community life. The opportunity to work with the Valley County Community Foundation Fund exemplifies The Sherwood Foundation’s hope to build partnerships of shared learning and collaboration in service to the common good we enjoy as fellow Nebraskans.

Hope in Action Ultimately, Valley County is a wonderful place to build a life with family, pursue the career of your dreams and connect with others to contribute to the greater good.

Innovation and Resourcefulness Igniting A Spirit of

Meaningful connections with youth directly impact Valley County’s future. To encourage youth to see their hometowns as places of opportunity, the VCCFF collaborates with local and statewide partners to design and grow a comprehensive entrepreneurship development program. Partners begin connecting with youth in elementary school to ignite an entrepreneurial spirit and engagement through experiences of Entrepreneurship Investigation Camp, Youth Entrepreneur Showcase, Career Exploration Day, Business Discovery Day, School to Work and internships and summer employment.

Furthermore, each high school senior is presented a flash drive detailing opportunities to live, work, play and give in Valley County with live links to community and school resources, as well as asked to complete a survey detailing their plans and aspirations for the future. Seventy percent of 2017 graduates indicated an interest in returning to their rural hometowns in the future. Fiftynine percent of soon-to-be graduates have an interest in owning their own business one day.

The VCCFF supports entrepreneurship development and youth engagement in the region by investing over $6,000 annually in funding, initiating community/school partnerships and leveraging external resources to implement programming and opportunities. Truly opportunities in Valley County are limitless.

“I have a vision for all communities within Valley County to partner with each other to create a culture of trust and innovative growth - communities where intergenerational citizens, businesses and community boards have a shared vision to continue to develop a holistic, vibrant community.”

Jodi Sell VCCFF Fund Advisory Committee Member

Cultivating An Artistic Culture

The VCCFF holds a strong commitment to enhancing our artistic culture and honoring the gifts and passions of community members in Valley County. In the past year, the VCCFF has partnered with The Golden Husk to host four artistic events including the musical Catherland, the Good Living Tour Festival, Rapunzel-a Missoula Children’s Theatre production and the Bluestem Band concert. The VCCFF contributed over $6,500 in endowment grants and leveraged an additional $3,000 to support these events for the enhancement of our creative culture. Christy Peterson, a native of Ord and member of the Bluestem Band shares, “The love of music has been passed down through generations and has been shared at every holiday and family event since I was a child. It has been an exciting venture to join my sister, cousins and friend to continue this legacy through our band Bluestem. The opportunity to perform in our hometown is very special.” The positive outcomes of building our artistic culture through experiences with local performances and touring companies are multi-faceted: a space is created for local artists to share their gifts and to be celebrated; youth are discovering new passions and gaining a broader vision of possibilities for the future; and touring artists are connecting with community members and gaining new perspectives regarding our local talent and wonderful quality of life in rural Nebraska.

Connecting Our Community Leaders

Stepping into its fourth year, SynoVation Valley Leadership Academy (SVLA) welcomed its largest level 1 class of twenty-eight since its onset in 2013. The 16-17 academy consists of three levels with the third level combining third and fourth year participants.

SVLA’s mission of building human capacity by developing entrepreneurial leaders who possess transformational skills to serve as dynamic family members, professionals, business owners and civic and servant leaders for the betterment of society has led to the growth of the program. SVLA continues to reach out to the public with its Blitz Series in which community members are able to attend monthly 90-minute workshops focused on time mastery, identifying a success culture, and discovering your passion at a minimal cost. Seeing the need to connect with the business sector of Valley County, SVLA developed a new series entitled Business Leadership which is rolling out in November 2016. Area businesses are invited to bring their teams to learn, discuss and implement tools for enhancing their organization’s culture and team performance. Unlocking Your Synergistic Leader, the SVLA youth curriculum continues to be implemented in the Ord and Arcadia school districts and SVLA held its first teacher/leader training of the curriculum in May of 2016 with ten participants from Valley and Sherman counties. The VCCFF continues to invest in SVLA by providing a $1,000+ sponsorship along with leveraging grant funds from external resources.

To learn more about SynoVation Valley Leadership Academy and how to become involved, visit www.synovationvalleyleadershipacademy.org or www.facebook.com/SynoVationValleyLeadershipAcademy.

Honoring Our Service Men & Women

Each year the VCCFF and Ord High School work together to honor area veterans and active service men and women on Veterans Day. During the ceremony, guest speakers share personal stories, the band and choir lead patriotic songs, junior high students write essays for the Patriot’s Pen contest and students present a special video to honor veterans. The VCCFF supports this program by hosting a reception for veterans and their families and purchasing an honorarium gift. This year the VCCFF made a $1,000.00 contribution, with funds from the unrestricted endowment and the Hometown Competitiveness Endowment, to the Loup Valley Veterans Memorial Park located in North Loup, to support the building of the memorial wall and purchase a bench for the park. Committee members, Deb Cadek & Elaine Asper commented, “We have been blessed with many generous donations and all volunteer workers making this Memorial possible. As a grateful community we hope to remember and honor all who have served and are currently serving in the armed forces to preserve our freedom. Veterans from Ord, Arcadia, North Loup, Scotia etc. as well as Veterans from across the country are welcome on our wall.”

Bricks have been purchased to cover every military conflict dating back to The Revolutionary War, Civil War and up to the current conflicts. Everyone is invited to honor a veteran with a brick on the Memorial Wall.

Donations may be sent to: Loup Valley Veterans Memorial Park c/o Phyllis Hanson P.O. Box 162 North Loup, NE 68859

Giving & Gratitude Building A Culture Of

“It is physically, emotionally and spiritually impossible to give and not receive in return.

It’s like tossing a pebble into a pond. That one single action causes a ripple effect that flows out in every direction which includes back to where you are standing.”

Darlene & Duane Psota, Members of VCCFF and Valley County Philanthropic Partners

Over the past four years the remarkable outcomes of the Big Give Event have truly exemplified the caring spirit of people who hold a vested interest in the vitality of Valley County. Cumulatively, financial contributions of the 2013-2016 Big Give events total over $300,000 from 1,655 donations!

The Valley County Philanthropic Partners welcomes all nonprofit organizations

within Valley County to participate in this partnership.

The VCPP hosts the Big Give to Valley County and organizes charitable giving workshops on an annual basis to enhance the philanthropic culture in our area.

Any level of participation by nonprofit entities will strengthen the group as a whole and benefit each organization. Working together through a united partnership

will continue to reap benefits for all of Valley County! The committee is currently holding monthly meetings on the second Wednesday of the month at 5:30 p.m. in the Central Community CollegeOrd Learning Center.

The VCCFF supports the VCPP committee by providing financial resources for

$40,047

$83,854

materials and marketing, staff support for communications and philanthropic educational workshops each year.

To learn more about the VCCPP and The Big Give to Valley County visit: www.ordnebraska.com/give and www.facebook.com/TheBigGiveValleyCounty.

$71,090

$95,288

454

310

446

445

DONATIONS

DONATIONS

DONATIONS

DONATIONS

2013

2014

2015

2016

Valley County Celebrating the People of

The VCCFF is honored to celebrate the people and organizations who make our hometowns a great place to live. Four awards were given by the VCCFF during the 2016 Annual Celebration in partnership with the Ord Area Chamber of Commerce and Valley County Economic Development. Nominees and award winners were voted on by VCCFF donors and Fund Advisory Committee Members. Numerous deserving people and organizations have been nominated during the past three years. Valley County is blessed with generous, passionate people who work for the greater good!

Community members and organizations honored with these philanthropic awards presented by the Valley County Community Foundation Fund include: Pat & Kathy Waldmann ~ 2016 Outstanding Public Service This award honors individuals or organizations that provide valuable public services to the people of Valley County.

Kassidy Mundt ~ 2016 Exceptional Young Citizen Honors those individuals 18 years old or younger, who have made notable contributions of time and talent to their school, community and Valley County.

Please join us for the

2017 Annual Celebration February 3, 2017 Hosted by VCCFF, Valley County Economic Development & Ord Area Chamber of Commerce.

Joel Kokes ~ 2016 Dynamic Young Community Leader Individuals 30 years old or younger who are awarded for making significant contributions as an emerging leader in their personal life, workplace and community.

SynoVation Valley Leadership Academy ~ 2016 High Impact Organization Non-profit organizations that demonstrate good stewardship of dollars and exhibits community impact and involvement for the betterment of Valley County.

Monsanto Fund Award

Fund Advisory Committee Member, Chuck Zangger nominated the VCCFF for the 2016 Monsanto Funds America’s Farmers GROW Communities donation of $2,5000.00.

America's Farmers Grow Communities recognizes the important contributions farmers make, and helps them grow their communities by supporting local nonprofit organizations. Since the program started in 2010, more than $22 million has been directed to organizations across rural America. In 2016, over 1,300 nonprofits in 40 states received donations from American's Farmers Grow Communities, sponsored by the Monsanto Fund and winning farmers.

“My dream for the future of Valley County is that it will be a place where people will want to come to, not just be from.” - Chuck Zangger, Fund Advisory Committee Member

Time, Talent & Treasure Giving Back To The Future...

Tammy Kittle

Tammy Kittle has possessed a burning passion for entrepreneurship and owning a business since she was a child. “When I was young, I always dreamed about starting a business to make money, but there wasn’t much information or support for youth business creation,” stated Tammy. During college, Tammy worked in an auto body shop, side by side with technicians, discovering her passion and eventually her life’s work! With the support of her husband, Rod Kittle and her family, Tammy built a shop and started her own business, Tammy’s Auto Body, in Ord, 22 years ago. Now she is giving back to her community by inspiring her children to start their own businesses. Her daughter, Shelby owns two businesses including a custom airbrushing business featuring fishing lures, mailboxes and wall art and a honey bee business raising bees and harvesting honey. Tammy’s son, TJ raises and sells numerous varieties of pumpkins and owns a custom decal business. Both kids continue to grow their businesses and they are saving their profits to fund their college educations.

Tammy also mentors other youth entrepreneurs in the community. A special way Tammy supports all youth business owners is to pay for radio ads featuring youth promoting their businesses during annual VCCFF entrepreneurship events. “I appreciate the community programs which teach youth critical communication and business skills and provide them support to pursue entrepreneurial ventures. The radio ads give youth marketing experience and the opportunity to connect with the public.” Tammy’s advice to youth is to dream big and take math, computer and business classes so they have the skills necessary to launch their own businesses in the future.

Sharing Her Passion to Impact Youth

Bob & Jean Stowell Gifting With An IRA Rollover

As natives of Ord and Valley County, Bob and Jean Stowell are passionate about ensuring that their hometown area is thriving now and in the future. Bob and Jean are also founding members of the VCCFF and they have served as volunteers on the Fund Advisory Committee (FAC) since its inception. During the past year, they chose to give back to their community with an IRA Rollover contribution. Donors who are seventy and one-half years old can effectively utilize a charitable IRA rollover to benefit their favorite charity.

This method of giving can be beneficial to the donor, as the distribution from the IRA is not counted as income. “Jean and I chose to use this method of gifting in 2016 to give $25,000.00 to the Unrestricted Endowment for the benefit of the Valley County Community Foundation Fund. We were motivated to make this gift to the Unrestricted Endowment because we want to ensure that Valley County’s future leaders will have discretionary resources to address community needs and pursue opportunities in the future.”

Kevin & Kelly Kreger

Kevin and Kelly moved their young family from a suburb of Chicago to Valley County because they value the quality of life in rural Nebraska. Kevin and Kelly are both entrepreneurs and they are enjoying numerous opportunities to live and work in their areas of passion while raising their family in a safe, friendly environment. As a fund advisory committee member of the VCCFF, Kevin contributes to the unrestricted endowment with a monthly donation using the automatic withdrawal option, as a convenient way to give back to the countywide community.

Giving Back With A Monthly Gift

“Through local charitable giving people are creating a legacy in our community. With contributions now and planned giving in our wills and estates to local endowments we can ensure that our dollars benefit and empower community vibrancy for generations to come!”

Ray Scott, VCCFF Advisory Committee Member

Thank You We deeply appreciate all 2015-2016 donors and volunteers and their support.

Ray Scott Steve and Dan Vech Ag Pro Insurance Darwin & Linda Volf Trent & Heidi Proskocil Jodi Sell GLOW Leadership Bryant & Kristina Foth Foth Agricultural Services Maschkaâ&#x20AC;&#x2122;s Building Center Gene & Jody McCoy Bob & Jean Stowell Dennis & Christy Proskocil Bethanne Kunz Roger & Vickie Lansman Dean & Traci Fahrenholz Mark & Dahn Hagge Crystal Ramm Logan & Jennifer Plate Dale & Janie Zadina Joe & Chris Wadas Wadas, Inc Valley County Health System

Jason & Karla Ritterbush Windy Mountain, Inc. Springdale Title & Realty, Inc. Larry D Schultz Duane & Darlene Psota Dan & Laura Pokorny Harold & Lisa Benton Benton Inc. Mick Puckett Christy Peterson Riverside Physical Therapy, LLC Chuck and Carrie Zangger Zangger Popcorn Hybrids Kevin and Kelly Kreger KNLV Radio Tammy Kittle Tammyâ&#x20AC;&#x2122;s Auto Body Gerald & Janis Severson Lane Gewecke Consulting Quiz Graphic Arts, Inc. Monsanto Fund-grant John & Alyce Wozab Legacy Fund-grant Dan & Linda Studnicka

Donors listed above have given to the VCCFF direct account.

If we have unintentionally omitted your name, please contact us.

Over 150 donations were given to the VCCFF for the benefit of other accounts within the Fund during 2015-2016.

Ten Tools

for Charitable Gift Planning 1. Charitable Bequest

A provision in your will that creates a legacy

2. Gift of Retirement Plans Avoids potential double taxation

3. Gift of Life Insurance Easy, convenient and flexible

4. Donor-Advised Fund Provides maximum tax benefits and grandmaking flexibility

5. Charitable Gift Annuity Provides lifetime income

6. Gift of Securities Offers triple tax benefits

7. Gift of Ag Commodities A tax-wise gift compared to cash

8. Gift of Real Estate Provides significant tax advantages

9. Charitable Remainder Trust Increases income and bypasses capital gains taxes

2015/2016 Memorials and Honorariums 10. Wealth Replacement Trust Helps provide for family and charity

Giving to the VCCFF offers people an opportunity to remember or honor a special person or event. This is a meaningful way to present a lasting tribute to a loved one or to honor a special occasion or outstanding achievement.

Memorials

Luetta Hurlbert Jim Spilinek Sherri Ehresman Marlene Smith Ivan Sorensen Ardella Sorensen Jim Smith Dean Jonak Denver Fahrenholz

Memorials

Richard James Beran Wesley Sell Rocky Severson Eunice Markley Keith Peterson Grace Coufal Laureen Krajnik Regina Mary Lech Carol Simpson

Memorials

Rose Sevenker

Honorariums

Piskorski Dental Loup Valley Redi-Mix Foth Agricultural Services Cassidy's Backroad BBQ & Grill Cobblestone Inn & Suites

VCCFF Designated Fund Balances

129 S. 16th Street, P.O. Box 56 Ord, NE 68862 www.ordnebraska/give/valley-co-communityfoundation-fund www.facebook.com/VCCFF For more information contact: Coordinator ~ Dahn Hagge (308) 730-2294 vccommunityfoundation@gmail.com

(September 30, 2016)

General Account Unrestricted Endowment HomeTown Competitiveness Endowment Geweke Family Youth Endowment Geweke Family UMC Endowment Ord Library Endowment Ord Presbyterian Church Term Endowment Ord Golf Club Loup Valley Ag Society Valley County Leadership Total Ending Balance

The Valley County Community Foundation Fund is an affiliated fund of the Nebraska Community Foundation.

$3,534.64 $171,069.31 $166,782.10 $130,551.59 $106,134.42 $18,603.72 $56,555.41 $9,836.45 $17,337.15 $2,586.50 $724,513.66

I (We) would like to partner with VCCFF and offer my (our) support through a one time donation: In the amount of:_______________________

or by giving online at www.nebcommfoundation.org/fund/valleycounty

Please use this gift for the following: __________________________________________________________________________ Your name & address:______________________________________________________________________________________

This gift is given: In honor of _________________________________ In Memorial ____________________________________

A certificate will be sent to the family or business of each honorarium and/or memorial gift. Please list the name & address you wish for the certificate to be sent:__________________________________________________________________________ __I would like information about making a planned gift-cash, securities, real estate, grain, livestock, life insurance, trust/will

(Monthly Gift:) I (we) wish to make a tax-deductible gift on a monthly-basis. I (we) authorize the Nebraska Community Foundation and my (our) financial institution to initiate a monthly withdrawl form the bank account listed below. I (we) understand that this gift will be deducted from my (our) account on the last business day of each month: Amount $_____ per month

Please designate this gift to the following account (Choose One): General Unrestricted Endowment Other (specify): ________________

Beginning Month/Year: _________

Ending (Choose One):

No End Date

Ending Month/Year: _____________

Donor Name(s) (Please Print): ________________________

Financial Institution Name: __________________________

Phone Number: ____________________________________

Transit Routing Number: ____________________________

Address: _________________________________________

City/State/Zip Code: ________________________________

Signature of Account Owner: _______________Date: _______

Signature of Account Co-Owner: _____________ Date:_____

Branch (if applicable): ______________________________

City/State/Zip Code: ________________________________ Account Number at Financial Institution: _______________ Checking Account

Savings Account

I (we) authorize any necessary credit entries, debit entries and adjustments to my (our) account in connection with this transaction.

This authority will remain in effect until (1) The Nebraska Community Foundation has received written notification from me (or either of us) of its termination in such time and in such manner as to afford the Nebraska Community Foundation reasonable opportunity to act on it; or (2) the end date noted above.