DAF Form

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Philanthropic Investment Grant

Purpose. The donor (listed below) recommends that Realize Impact make a

* Indicates required field

Preferred Mode of investment *

Grant Recoverable Grant

Tentative amount *

to Beneficial Returns, LLC to provide loans to social enterprises addressing poverty in Latin America and Southeast Asia.

Realize Impact is organized and operated exclusively for the charitable proposes within the meaning of Section 501(c)3 of the Internal Revenue Code, with federal tax identifier 46-3594732, specifically to provide financial support, mentorship, and other assistance to early-stage socially-, environmentally-, health-, and community-conscious enterprises that are unable to obtain financing from conventional sources as a way to relieve poverty, create jobs, improve the health of communities and individual therein, and to improve the environment.

Not For. Grant funds may not be used to any extent to carry out propaganda, or otherwise attempt to influence legislation; or to influence the outcome of any specific election or to carry on, directly or indirectly, any voter registration drive; and all other restrictions per IRS requirements.

Investment. Realize Impact will have its investment committee confirm the potential impact of the recommended investment, confirm that this is a prudent use of funds, review the terms of an investment, and if needed, negotiate those terms. Realize Impact shall have full control and authority to decide whether to make the investment or not, as well as full control and authority to abide by the recommendations provided by the donor, or not. If the investment is found acceptable, Realize Impact will make the recommended investment. If for some reason the recommended investment is not made, the donation will be returned to the donor.

Fees. Donor will pay no Fees to Realize Impact.

Reporting. Realize Impact will provide updates on its investments to all donors on a quarterly basis and publish an impact report on an annual basis.

Return on Investment. (for Recoverable Grant only) The donor recommends that any return on this investment be donated to the following 501(c)3 public charity or private foundation:

Institution name *

Ownership. Upon receipt of the grant and completion of the investment Realize Impact is the owner of the asset. Any ongoing investment management decisions, such as exiting an investment, are the full responsibility of Realize Impact.

Be Nice. The donor will not, in public, make derogatory, disparaging or critical statements about Realize Impact. Realize Impact will not, in public, make derogatory, disparaging or critical statements about the donor.

Representation. Realize Impact is a nonprofit corporation in good standing in the State of Washington, with tax exempt status under Section 501(c)3 of the IRS tax code.

Termination. This agreement shall expire one year after Realize Impact reports that no further value is reasonably expected from the recommended investment.

Washington. This contract is governed under the laws of the State of Washington.

Whole Contract. This is the complete contract between the donor and Realize in regards to this donation. There are no other amendments.

Other relevant information *

share why you believe this is a good investment: *

Name *

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For more details, contact us or directly e-mail Ted Levinson at ted@beneficialreturns.com.

Grants and Recoverable Grants should be made payable to:
Realize Impact
attn: Beneficial Returns
271 Winslow Way E #11548
Bainbridge Island, WA 98110
The EIN for Realize Impact is 46-3594732.

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Philanthropic Investment Grant

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