Global Mission: International Funds Transmittal

This form is a tool for synods, congregations, and organizations to send funds internationally in compliance with the federal U.S. Patriot Act.

Please review the Frequently Asked Questions (FAQs) before completing this form.

* indicates a required field

A. Individual contact information - Please provide the following:

Your name:

Your title:

Your e-mail address:

Your e-mail address (again):

Your phone (###-###-####):

B. Sender of funds - complete ONE choice:

Note to synod offices: During this initial trial period, only you will have access to this form, but you may use it to forward or report restricted gifts given by ELCA congregations or institutions.

1. ELCA synod:

Note to congregations and institutions: During this initial trial period, the following two options are disabled because they are not directly available for you, but your synod office may be able to forward or report gifts on your behalf (see B.1. above).

2. ELCA congregation ID number:

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3. Other ELCA-related organization:

Name:
Address:
City/State/Zip:		,

C. Recipient of funds - complete ONE choice:

1. International companion of an ELCA synod (in a companion-synod relationship):

2. Other international recipient:

Name:
Address:
City/State/Zip:
Country:

D. Funds:

Amount of funds to be sent:

$ *

For what country are funds intended:

Breakdown of funds:

What are the intended uses of these funds?
If the funds are to be used for more than one purpose, please provide the other intended uses:
*

E. Remitting of funds - complete ONE choice:

We are sending these funds to the ELCA Global Mission unit to request that Global Mission verify compliance with the Patriot Act and then transmit funds to the international companion or recipient noted above in Section C.

The funds will be sent to ELCA Global Mission using one of the following methods:

The funds need to arrive:

	With the next transmittal of funds (recommended – see Frequently Asked Questions (FAQs))
	Within one month of receiving funds (please explain with a note in "Comments" below.)

We are informing you that we are remitting these funds directly to the international companion or recipient noted above in section C.

We understand and have complied with the U.S. Patriot Act to the best of our abilities, as explained in the guidelines for sending funds in compliance with the Patriot Act.

F. Comments (Optional):

Receive regular updates through Global Links, a free monthly e-newsletter from ELCA Global Mission. Check here or subscribe at http://www.elca.org/global-links

How are you involved in ministry or relationships in other countries? Take a Global Engagement Survey! Your answers will help us learn how Lutherans are participating in God's work around the world. Go to: http://www.elca.org/globalsurvey