Text Box: DO NOT USE THIS FORM FOR A SPONSORED PROJECT. A Sponsored Project generally involves a proposal with a set of objectives, a specific statement of work to be done, a detailed budget, or a specified period of performance; use the Sponsored Project Transmittal Form for such projects. The policy that governs the definition and handling of gifts can be found in the University of Wisconsin System Financial and Administrative Policy Paper Extramural Support Administration (G2) at uwsa.edu/fadmin/gapp/gapp2.htm.

University of Wisconsin–Milwaukee
Graduate School
Research Services and Administration

DONOR INFORMATION

Donor Name
  If UWM Foundation, provide UWMF Account Number
Donor Address Street:
City:
State:
Zip:


Gift Acknowledgment Letter Sent? Yes
No
RECIPIENT AND GENERAL INFORMATION
Individual/Unit Recipient Org Code
Admnistering Unit Org Code
Purpose
Description of Gift-in-Kind or Donor's Intent for Monetary Gift:
Matching Yes
No 		   
  If Yes, name Sponsor to be matched:
MONETARY GIFT INFORMATION
Amount $
 

Establish New Acct
Add to Acct #133-
Add to Trust Acct #162-

GIFT-IN-KIND INFORMATION
The following information is required for Inventory/Insurance Purposes.
Estimated Value $
Location of Item Building Room #
Contact Person
Equipment Mfr
Serial #
Model #

Does the Equipment:
YES
NO
  

Include radioactive components or use radioactive materials?
(If yes, attach written approval from Environmental Health, Safety and Risk Management)
 

Require special training for operator safety?
(If yes, attach written approval from Environmental Health, Safety and Risk Management)

 
Require a maintenance contract?
If yes, provide estimated yearly cost.
Cost: $

Require any action involving space, remodeling or construction?
(If yes, attach a description of what is required and estimated cost.)