State Charities

Illinois State Council K of C Charities, Inc. http://www.illinoisknights.org 2016-2017 State Charities Lead Me, Guide Me, Lord

Illinois State Council K of C Charities, Inc. 2016-2017 State Charities ID DRIVE REMINDER Attention District Deputy The Council ID Drive Report was Due November 1 st Have All Your Councils Sent in Their Report Along with All ID Money Collected to Date? Have All Your Councils Sent in Their Request for Distribution? Councils can continue to raise additional ID Funds and file an amended ID report to send with funds to the State Office. Let s Get the Paperwork Done & Enjoy the Satisfaction of Giving! Lead Me, Guide Me, Lord

Illinois State Council K of C Charities, Inc HOW TO COMPLETE THE ID REPORT & REQUEST FOR DISTRIBUTION FORMS DOWNLOADED FROM THE WEBSITE VISIT: http://www.illinoisknights.org Locate and click on the CHARITIES tab at the top left hand corner of the home page Scroll down to the ID fund drive section and click on the title Scroll down to the ID Report Form in the Excel format This form is designed to interact with your computer. Complete the form as you normally would, however, the computer will do the math for you. 1. Enter your gross revenue-the computer will calculate your 10% due to the State Council. 2. If you participate in the State General liability program, click in the $50 insurance box and click DELETE. If you do not participate in the insurance program, skip to the next line. You must pay the $50.00 3. If you wish to donate to the Home Loan program, enter the amount on line 2C 4. Line 3 SUBTOTAL should now show line 1 minus all amounts from line 2a,b,and c 5. Enter all your expenses as you normally would 6. The Amount you have to spend should appear on line 5 7. Line 6 should automatically show the amount of your check to Illinois KC Charities, Inc. You re done! Save this form to your computer for your records and print a copy to accompany your check. Remember to send all receipts for expenses claimed for Advertising and Miscellaneous Expense The ID Request for Distribution can be found on the same page on the website and is also interactive. Remember to enter the amount from your report Line 5, at the top of the column on your request for Distribution. As you enter your charities and their donation amounts, the computer will automatically subtract them from your amount to spend at the top of the page. When you are done listing your charities, the balance left in your account is shown at the bottom of the form. At this time, if there are funds remaining, you can donate them to the homes program on the line provided. If you choose to retain any remaining funds, a new Request for Distribution will be returned with your requested checks. Save this form to your computer for your records. At this time you can either send it to the state office via US mail or as an attachment via email to: donna@illinoisknights.org or Fax 815-935-2078 Remember to add your email address to both forms. If there are any questions this is the method the State Office will utilize to communicate with you.

Illinois State Council K of C Charities, Inc. http://www.illinoisknights.org REPORT OF COUNCIL INTELLECTUAL DISABILITIES FUND DRIVE DUE: NOVEMBER 1ST Council # City GK IRS ID Date 1 2 GROSS REVENUE FROM DRIVE State Council Deductions: 2a 2b 10% of Gross Revenue (line 1) for State Program Liability & Accident Insurance $ - $50.00 * If your council is participating in the new State Liability Insurance Program, please delete this deduction 2c 2d Council donation to Intellectul Disabilities Home Loan Fund TOTAL STATE COUNCIL DEDUCTIONS (Line 2a +2b + 2c) $ * 50.00 3 SUBTOTAL - Council Monies (line 1 minus 2d) $ (50.00) 4 Allowable Council Expenses: 4a Candy Cost ** 4b Postage for Business Solicitations*** 4c Apron Cost *** 4d Advertising ** 4e Miscellaneous** (requires explanation) ** These expenses require receipts 4f Total allowable Council Expenses (line 4a + 4b + 4c + 4d + 4e) $ - 5 6 BALANCE AVAILABLE FOR COUNCIL DISTRIBUTION (line 3 minus 4f) This is the amount your council has to distribute and should appear on the first line of your Distribution Request TOTAL REMITTANCE TO STATE CHARITIES (line 2d+5) $ $ (50.00) - CHECK NUMBER FOR AWARD CONSIDERATION # of KC Volunteers # of non-kc Volunteers TOTAL DRIVE VOLUNTEERS Mail WHITE COPY with your check Mail YELLOW COPY to your District Deputy Keep PINK copy for your Council Files MAIL TO Illinois State Council K of C Charities, Inc. PO Box 681 Kankakee, IL 60901-0681 ** The above expenses require receipts to be filed with the State Council Office or with the report. *** The above expenses are 'ALLOWABLE' under IRS and INTELLECTUAL DISABILITIES Committee Rules. If any questions arise regarding these 'ALLOWABLE' expenses, please call the Illinois State Council Office Sign GK Sign FS

REQUEST FOR DISTRIBUTION ILLINOIS STATE COUNCIL K OF C CHARITIES, INC. Council: # City: G.K.: Date: Checks Needed by: / / Distribution requests are payable only to Intellectual Disabilities Organizations who are approved by Charities Inc and registered Charitable Organizations. ACCOUNT BALANCE TO DISTRIBUTE: (Prior unspent balance +Line 5 of CURRENT Report Log) ALL REQUESTS MUST INCLUDE COMPLETE MAILING ADDRESS NAME ADDRESS Street: 1 City: State: ZIP: Street: 2 City: State: ZIP: Street: 3 City: State: ZIP: Street: 4 City: State: ZIP: Street: 5 City: State: ZIP: Street: 6 City: State: ZIP: Street: 7 City: State: ZIP: Street: 8 City: State: ZIP: Transfer to Illinois Homes Loan Program (a program of the Illinois State Council K of C Charities Inc.) [Do not include if previously deducted on Homes Report] Please Mail These Checks to: DISTRIBUTION AMOUNT REQUESTED NEW BALANCE [Account balance listed above minus distribution amount requested] $0.00 AMOUNT $0.00 $0.00 [Name] [Title] [Address] [City, St Zip] GK Name Phone # NOTE: Completion of this form with GK Name constitutes official endorsement of this request and authorizes Illinois K of Charities to prepare checks as indicated above.

Preparing For The ID Drive In 2017-2018 Appoint your ID Chairman. Complete the ID Chairman form available on the State Website with his information and send to the State Office via US mail; Fax 815-935-2078, or email at: Vicki@illinoisknights.org A mailing of all ID forms and information will be made. If we do not have your ID chairman s name, he will not receive this vital packet! Request and obtain the necessary permissions to collect from your city or municipality. This must be done Now, December, January or as soon as possible to avoid conflicts with other organizations for the regular collection weekend. Please do not delay on these approvals! Determine your collection points and investigate whether they will need a proof of insurance or need to be additionally insured on our insurance. Contact the State Office for more specifics: 815-935-2262 or email: donna@illinoisknights.org Consider sending solicitations to local businesses utilizing the ID pamphlet to illustrate where the money goes. Discuss with your council to determine the number of cases of Tootsie Rolls, or Banks you will be ordering. Start to prepare your collection assignments. a. Children under the age of 18 may not collect on street corners or intersections b. Children can collect outside store fronts with adult supervision. c. Other members can be utilized to collect outside church, or at athletic events using a card table to sell candy or banks. d. If you plan on collecting in downtown Chicago, make arrangements with ID Chairman Ted Glaser at 708-203-2277 or email at: tedglaser@aol.com

Don t send in your ID Report with a check for only the amount on Line 5! Line 6 is the correct amount of your check Don t forget to send the State Council Office your pink copy of the Candy order Form before your drive! Don t forget receipts are needed for any expense over $100 Don t claim expenses for a meal (s), if the cost is over $5.00 per person. Do not forget to include your meal expenses on the Miscellaneous Line. Do not forget to attach your receipts for meals so we are in compliance with Federal regulations Don t forget if you claim meal expenses you must include the # of KC and non-kc volunteers in the space provided in the Award Consideration Box on the report form. Do not allow children to collect on the streets! Collection Canisters Expense are not deductible Coin Counting charges are not deductible Not adhering to these rules will cause your funds to be unavailable for distribution in a timely manner. Allow 6 weeks for processing and issuance and mailing of checks. Questions concerning your ID funds should be directed to: donna@illinoisknights.org Cost to travel to deliver candy or pick up cash collections are not deductible Distributing funds to locations other than those included on our Approved Charities List is not allowed. Complete a new application available at the State Website. Allow 6 weeks for approval

Illinois State Council K of C Charities, Inc. Po Box 681, 187 S. Indiana Ave, Kankakee, Illinois 6090l Email: illinoiskc@illinoisknights.org Website: www.illinoisknights.org COUNCIL NAME COUNCIL NUMBER Worthy Grand Knight: MARK YOUR CALENDAR! The 49 th Annual ID Fund Drive will be held on SEPTEMBER 15, 16, 17, 2017 ALTERNATE DATES OF DRIVE COVERED UNDER OUR LIABILITY INSURANCE POLICIES: Sept 1-3, Sept 8-10, Sept 22-24, 2017 Collection dates other than those listed MUST BE APPROVED BY THE CHARITIES DIRECTOR NOW is the time to submit your council chairman name and start planning for the 2017-2018 ID Fund Drive. Please complete this form, EVEN IF THE CHAIRMAN IS THE SAME AS IN PAST YEARS, and return by March 1, 2017 so information packets are sent to the correct person in early spring of 2017. Chairman Phone ( ) - Address PO Box # City ST Zip - Email Address: (If certificates can be sent here) For those councils that participate in the General Liability Program, the cost of the ID insurance is included in your annual premium. For those who do not participate in our program, the cost is $50 and is paid on the ID Report form. INSURANCE RIDERS ARE AVAILABLE IF REQUIRED. PROVIDE THE INFORMATION AS REQUESTED BELOW. BE SURE TO INDICATE IF THEY REQUIRE SPECIAL LANGUAGE (provide sample) or want to add l Insured Business Name, * Address *City State, Zip Code Date of Drive Business Name, * Address *City State, Zip Code Date of Drive Business Name, * Address *City State, Zip Code Date of Drive If additional lines are necessary, please use the back of this form and check here * Must be completed! RETURN THIS COMPLETED FORM TO: ILLINOIS STATE COUNCIL KNIGHTS OF COLUMBUS P.O. BOX 681 Kankakee, Illinois 60901-0681

Illinois State Council K of C Charities, Inc. P. O. Box 681, 187 S Indiana Avenue, Kankakee, Illinois 60901-0681 Phone 815-935-2262 Fax 815-935-2078 Email: illinoiskc@illinoisknights.org Website: www.illinoisknights.org PLEASE COMPLETE YOUR ORGANIZATION S INFORMATION BELOW: YOUR EXEMPT ORGANIZATION NAME: SHIPPING ADDRESS: MAILING: City: State Zip code: +4 Zip Contact Name (please Print) Phone ( ) - Website: Dear Applicant; Council Sponsor? # Name: As you may know, for over 49 years the Illinois State Council K of C Charities, Inc. Intellectual Disabilities Fund has helped thousands of individuals by providing financial support to qualified organizations that operate programs on behalf of persons with Intellectual disabilities. To comply with federal and state regulations, to affirm that funds are being distributed in accordance with current fund guidelines, and to maintain an up-to-date listing of qualified organizations, we are asking each charitable organization to provide information about how the funds received are to be used. Please assist us by responding to the following: 1. Our Program which received funding from the Illinois State Council K of C Charities, Inc. Intellectual Disabilities Fund supports individuals with the following disabilities (as identified by the Federal Rehabilitation Act -Section 504): [Please indicate as a percentage, either A) the number of individuals in your program OR B) the total budget expended to assist individuals with a particular type of mental disability. % - Intellectual Disabilities [Intellectual functioning level (IQ) is below 70-75; significant limitation exist in two or more adaptive skill areas; and the condition is present from childhood (defined as age 18 or less). % - Learning Disabilities % - Cognitive Impairments % - Autism % - Other (Identify) = [100% Total] 2. Please provide your Federal Employer Identification Number: FEIN# - WE DO NOT WANT YOUR ILLINOIS E # 3. We are registered tax exempt Section 50lC 3 organization as established by the US Internal Revenue Code as a Charitable Entity Governmental Entity Dated a box to describe your group *4. Please attach a copy of the letter you received, in which the US Internal Revenue determined you were a 501C 3 organization. (Schools & Churches are exempt, but we would like a copy) NO FUNDS CAN BE DISBURSED WITHOUT A COPY OF THIS CORRECTLY COMPLETED FORM AND YOUR 501c 3 LETTER NOT SENDING A COPY OF YOUR 501c3 LETTER COULD DELAY YOUR APPROVAL Lead Me, Guide Me, Lord

Illinois State Council K of C Charities, Inc. 187 South Indiana Avenue, PO Box 681, Kankakee, Illinois 60901-0681 Email: illinoiskc@illinoisknights.org Website: www.illinoisknights.org EMPLOYERS WITH CHARITABLE PROGRAMS Because municipalities are banning collections on street corners, we must find an alternate source of collections. To that end, we have compiled a list of well known corporations that offer some type of funding to 501C3 organizations such as the Illinois State Council K of C Charities, Inc. YOU MAY WORK FOR ONE OF THESE COMPANIES AND NOT BE AWARE OF THEIR PROGRAM! For the most part, contact your Human Resources, Employment, or Benefits Department to obtain a form. READ closely the criteria for your matching funds/grants/payroll deduction programs. As you will note below, some have a specific criteria for approving the funds such as: only educational institutions (School Special Ed Departments), or only organizations within the community i.e. Wal Mart. Some employers have no stipulation other than the Giftee, (Illinois State Council K of C Charities) be a 501C3 organization. Even if your employer is not on this list, please consult your HR Representative to learn if they offer a program and if so, apply immediately! If you are an employer, consider creating a program of your own. Discuss this future possibility with your accountant to determine feasibility. COMPANY TYPE CONTACT INFORMATION AES CILCO ENERGY Charitable Matching Plan Obtain form from Local EDU 300 Liberty Street Peoria, IL 61602 309-677-5067 ALLSTATE Allstate Giving Payments See Local HR Department Payroll Deduction AT & T Employee Giving Program See local HR representative PO Box 3719 Payroll deduction Pledge Princeton, NJ 08543-3719 Newman Fund 877-761-5554 BANK OF AMERICA Matching Gifts Program Apply online at: www.bankofamerica.com Enter "Charitable Gift Program" in the SEARCH box at the top of the screen CASEY S GENERAL STORE Local Store Complete form at illinoisknights.org website CARGILL 1-1 Matching Gift Program www.cargill.com/about/ c/o Stacey Smida Seminaries citizenship/ Cargill Public Affairs employee_matching.pdf 952-742-4311

Illinois State Council K of C Charities, Inc. 187 South Indiana Avenue, PO Box 681, Kankakee, Illinois 60901-0681 Email: illinoiskc@illinoisknights.org Website: www.illinoisknights.org COMPANY DONATION TYPE CONTACT INFORMATION EXCELON CORPORATION Donation www.exeloncorp.com Application GRANGER Matching Gift Program See Charitable Contributions 100 Grainger Parkway Coordinator Lake Forest, IL 60045-5201 847-535-1000 www.grainger.com J P Morgan Chase (main Office) Matching Gift Program Consult Local Manager PO Box 7899 Princeton, NJ 08543-7899 IBM Employee Charitable uscamp@us.ibm.com Contribution Campaign Payroll Deduction ITW (all units) 3-1 Matching Funds See unit HR representative ITW FOUNDATION ID Fund only 3600 W Lake Ave Glenview, IL 60026 Email: itwfoundation@itw.com MASTER CARD International matching mastercard@easymatch.com International Matching Gifts Program Gifts Program c/o JK Group Inc PO Box 2195 Princeton, NJ 08543-2195 877-698-5960 MOBIL FOUNDATION, INC Matching Gift Program See your benefits coordinator Employee Benefits Coordinator ID - Special Ed Only 3225 Gallows Road Fairfax, VA 22037-0001 MOTOROLA FOUNDATION Matching Gift Program Matching Gifts Administrator 910 Highland Park Dr ID - Special Ed Only Eureka Springs, AR 72632 501-253-5414 NIKE, INC Matching Gift Program nike@easymatch.com Po Box 7215 Based on a minimum of 25 Princeton, NJ 08543-7215 hours per gift 888-671-4438

COMPANY DONATION TYPE CONTACT INFORMATION PPG INDUSTRIES FOUNDATION Matching Gift See Local HR representative Matching Gifts Program ID only eligible One PPG Place "Special Education" only Pittsburgh, P 15272 412-434-2962 SUNSTRAND CORPORATION Matching Gifts Program See Local HR representative 4949 Harrison Ave ID SPRED groups PO Box 7003 only ["special Education"] Rockford, IL 61125 POTASH CORP Payroll deduction Pledge See HR representative 1101 Skokie Blvd, Ste 400 administered by United Way Northbrook, IL 60062 WAL MART Matching Grant Must register with Illinois State Council WAL MART "Volunteerism Always Pays"- See Store Community Associate. Based on the hours Involvement Rep Volunteered in a 6 month period as: a bingo caller, Secretary for Council Or Assembly, ID collection volunteer, ID chairman etc.

Help us be #1 in Charities Order Wide Again! Whenever you donate funds to Special Olympics, whether it is directly to Special Olympics, or a School District's Special Olympic Team, or a Group's Special Olympics Program or to a Torch Run Complete a Form 4584 "Partnership Profile Report with Special Olympics" and send it to the Supreme Council dept. of Fraternal Mission as well as the State Office When receiving an ID check from the State Office payable to any of the above Special Olympics entities, you will also receive a Form 4584 for reporting this donation. This year we were #2 in Charities...behind Texas... WE CAN DO BETTER! Send the completed form to: fraternalmission@kofc.org And Vicki@illinoisknights.org We CAN Regain #1 With YOUR help!

Illinois State Council K of C Charities, Inc. 2016-2017 State Charities Attention District Deputies and Grand Knights! Help Strengthen our Partnership with Special Olympics! File your Partnership Profile Report with Special Olympics Supreme Form #4584 Due January 31, 2017 This is a VERY IMPORTANT form which reports events/man hours/contributions for the 12-month period ending December 31, 2016. Be proud of your council s support of Special Olympics and begin to gather your information Today! Form 4584 can be opened and completed online, or printed out and completed, but cannot be submitted online at this time. It must be printed and sent via US mail or email, (addresses below). Also remember to submit a copy to the State Office, your District Deputy, and save a copy for your council files! Form 4584 can be found at the Supreme Website, go to: www.kofc.org, click on For Members click on Resources then click Forms To access Form 4584 from the State Council Website, go to www.illinoisknights.org, scroll down to the bottom of any page, under Quick Links click on Forms, on the right side under Supreme Council Forms select clicking here Postal mailing address: Supreme Council Dept. of Fraternal Mission 1 Columbus Plaza New Haven, CT 06510-3326 Email: fraternalmission@kofc.org Lead Me, Guide Me, Lord

PARTNERSHIP PROFILE REPORT WITH SPECIAL OLYMPICS INSTRUCTIONS FOR COMPLETING REPORT FORM For Twelve Month Period Ending December 31, 2016 20 *IMPORTANT * Please type or print legibly. * Please record information to reflect members and their families participation. * INCLUDE SQUIRES AND 4TH DEGREE ASSEMBLY TOTALS IN THIS REPORT. * Include financial contributions and hours of community service from all Special Olympics programs (i.e. Family Leadership and support, Invest in a Life, etc.) * UNITS IN THE PHILIPPINES SHOULD REPORT ALL FINANCIAL DATA IN PESOS. * MAKE A PHOTOCOPY OF SURVEY REPORT FOR YOUR COUNCIL FILE. Due By: JANUARY 31 SECTION I. VOLUNTEER HOURS PROVIDED BY K of C MEMBERS AND THEIR FAMILIES TO SPECIAL OLYMPICS THROUGHOUT THE CALENDER YEAR: Volunteer service with all levels of Special Olympics by Council members and their families games, events, programs, special initiatives, etc. SECTION II. NUMBER OF K of C VOLUNTEERS AT SPECIAL OLYMPICS GAMES AND EVENTS: Event-Specific K of C Volunteers announcer, athlete escort, awards presenter, competition volunteer, family services, food services, lane escort, lane judge, scorekeeper, timer, transportation, venue services, etc. Year-Round K of C Volunteers program management, administration, clerical, planning, games management, sports training, Special Olympics Board Member, coaching, etc. SECTION III. NUMBER OF EVENTS IN WHICH K of C MEMBERS AND FAMILIES VOLUNTEER: All events involving Special Olympics state, national, international games, community programs, etc. Special Olympics Initiatives: - Athlete Leadership Programs - Family Leadership and Support - Schools and Youth - Healthy Athletes - Law Enforcement Torch Run SECTION IV. TOTAL FUNDS CONTRIBUTED TO SPECIAL OLYMPICS: Local, state, and national contributions, Healthy Athletes, donations to Special Olympics initiatives, etc. Donations to Special Olympics Support Programs: - Online Donation - Mail / Telephone Donation - Planned Giving - Matching Gifts - Wedding / Special Occasion Favors - Monthly Giving - Frequent Flyer Miles SECTION V. NEW EVENTS ADDED THIS YEAR: Please provide the names of any new sporting events that your Council has contributed to or added to Special Olympics on any level this year. SECTION VI. SPECIAL OLYMPICS AFFILIATIONS: Please provide the names of any Special Olympics groups, organizations or teams with which your council is affiliated or actively supports. Please indicate if this is a local, regional, or state organization or group. 4584 11/11

PARTNERSHIP PROFILE REPORT WITH SPECIAL OLYMPICS For Twelve Month Period Ending December 31, 2016 20 Council Number Location city/town state/province I. Volunteer Hours provided by K of C members and their families to Special Olympics throughout the calendar year. 1. State Games/Events 2. Regional Games/Events 3. Local Games/Events III. Number of Events in which K of C members and families volunteer. 1. State Games/Events 2. Regional Games/Events 3. Local Games/Events TOTAL VOLUNTEER HOURS II.Number of K of C Volunteers at Special Olympics Games and Events. 0 TOTAL EVENTS IV. Total Funds Contributed to Special Olympics. 1. State Games/Events Dollars Only 0 EVENT-SPECIFIC VOLUNTEERS 2. Regional Games/Events 1. State Games/Events 3. Local Games/Events 2. Regional Games/Events 3. Local Games/Events Total Event-Specific 0 TOTAL CONTRIBUTIONS V. New Events Added This Year. 0 YEAR-ROUND K of C VOLUNTEERS 1. State Games/Events 2. Regional Games/Events 3. Local Games/Events VI. Special Olympics Affiliations Total Year-Round 0 TOTAL K of C VOLUNTEERS (Event-Specific and Year-round) 0 Date: Mail Original To: Supreme Council Department of Fraternal Services. Mail Copies To: State Deputy, District Deputy, Council File. Available in electronic format at www.kofc.org (Signed) (Signed) (Grand Knight) (Financial Secretary) 4584 11/11