United Way unrestricted gifts support our core Impact Areas:  Healthy Community, Youth Opportunity, Financial Security, and Community Resiliency.  As a courtesy alternative giving option, the Donor Choice Program (DCP) allows individuals to direct their gifts to other 501(c)(3) Health & Human Service organizations.  This form is required annually to acknowledge and process these designations, which represent independent donor selections and do not imply official United Way agency affiliations.  Agencies must complete it to be considered for future donor-designated contributions through United Way’s General Campaign.

Important Note:  This form applies exclusively to United Way of Buffalo & Erie County’s General Campaign.  It does NOT fulfill qualification or compliance requirements for the State Employees Federated Appeal (NYS SEFA) or any other distinct fundraising efforts.

Please read carefully.  This form generally takes 10–15 minutes to complete.  Before you begin, have your organization’s EIN and current contact information available.  Helpful hints are provided throughout the document.  A confirmation email will be sent to the respondent's email after successful submission.

1. Submit one form per location:  Complete this form once for the specific branch or chapter location.  Duplicate submissions with conflicting data will cause delays.
2. Use standard capitalization:  Do not enter responses in all capital or all lowercase letters.
3. Most fields are required and marked with a red asterisk.  Leave other fields blank unless they apply to your organization.
4. Do not copy and paste:  Avoid pasting content directly from webpages, as hidden formatting, links, or HTML tags will cause errors.
5. Review for accuracy:  Thoroughly review all entries before submitting.  Submissions containing typos or data errors will cause processing delays.
6. Authorized signature required:  The person listed as the Signatory must be authorized to certify the information on behalf of the organization.

 Charitable Status & Anti-terrorism Conditions (please read carefully)

1. Funds received through United Way of Buffalo & Erie County and/or their donors are used for charitable purposes only.
2. We are currently eligible to receive tax-deductible contributions under section 501(c)(3) of the Internal Revenue Code (IRC) and continue to maintain a good standing with the IRS and State Charities Bureau or regulators. Our 990 or 990-N is current, if required to file, and our charitable status is currently valid.
3. In compliance with U.S. counterterrorism and economic sanctions laws, our organization affirms that it does not and will not knowingly provide financial or material support to any individual or entity involved in terrorism or subject to applicable sanctions, and that all funds received from United Way and their donors will be used in accordance with these laws, statutes, and executive orders.

Please review all details before submitting this form.

Before finalizing this, please ensure you have entered a complete main and/or mailing address. Once submitted, you will promptly receive a confirmation email from noreply@jotformsign.com. We appreciate your time and cooperation in helping us keep this process streamlined. Thank you!