The agency:
1. Provides direct health or human services within Genesee, Livingston, Monroe, Ontario, Wayne, and/or Wyoming County (the “Greater Rochester Area”) to Greater Rochester Area residents; and is not a federated fundraising organization, advocacy and/or membership organization.
2. Is tax-exempt under section 501(c)(3) of the Internal Revenue Code (“Code”) and not a private foundation under Code Section 509(a) Include as Attachment A, a copy of the agency’s most recent IRS determination letter.
3. Is current in meeting federal filing requirements. Include as Attachment B, a copy of the agency’s most recently submitted IRS Form 990 or 990‐EZ; confirmation of filing IRS Form 990‐N; or explanation of why the organization is exempt from filing an annual Form 990 with the IRS.
4. Will use any funds received through the United Way for charitable purposes only.
5. Is registered with the Charities Bureau of the New York State Attorney General, is current with all state filing requirements, and is compliant with the New York Nonprofit Revitalization Act. Include as Attachment C, a copy of the agency’s most recent CHAR500 filing (if registered) or, if exempt, a copy of your exemption notice from the NYSAG Charities Bureau.
6. Is governed by a Board of Directors. Include as Attachment D, a current Board of Directors listing with contact information.
7. Is in compliance with all applicable federal, state, and local laws, ordinances and regulations including, but not limited to, the USA Patriot Act and all applicable anti-terrorist financing and asset control laws.
8. Has received a copy of, understands, and will comply with the terms of the Donor Options Eligible Agency Standards of Participation , which may be amended at any time, at the sole discretion of United Way of Greater Rochester.
9. Upon approval, a payment authorization will be completed that provides directions for the payment of designations that may be made to the agency through United Way’s annual campaign.
10. Will not provide any benefit or privilege to donors who designate contributions to the organization in return for such designation.