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Form B

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Form B
All additions must be accompanied by this Form B. All additions to principal will receive units according to the most recent Valuation Date.
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‍Method of Addition: Check
To arrange to transfer funds electronically, contact your Regional Gift Planner or
the Endowment Coordinator at elcafoundation@elca.org or 800-638-3522.
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Deposits made on or after December 1, 2020 are added to the investment portfolio of the Fund based on the valuation
date preceding the date on which the Administrator receives the cash or liquidation proceeds and the properly completed Form B.
IMPORTANT NOTICE: Funds received by the ELCA Foundation will not be credited to Participant’s account until the ELCA Foundation receives the completed Form B.

DateParticipant NumberAccount NumberParticipant NameAccount NameParticipant Mailing Address: (as stated on the Participant Application)  ORCheck Here if address is newStreet/P.O. BoxCityStateSelectAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingZip Code
EmailTelephoneDeposit Amount**When you click Submit/Print below, your form data will be opened in another window where you can print. We recommend printing to PDF to save a copy for yourself and printing a paper copy to mail along with your check. You will not be able to revisit this form data—be sure to print or you will have to submit another form.**

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Make a distribution

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Make check payable to Endowment Fund of the ELCA and mail it with this form to:
Note: The ELCA Foundation strongly recommends using trackable delivery service when sending a check.

Checks mailed via USPS
Note: Please use trackable mail
Endowment Fund of the ELCA
P.O Box 1806
Merrifield, VA 22116-8009
Checks sent by FedEx, UPS, or any deliveries requiring a signature.
Endowment Fund of the ELCA
P.O. Box 1806
100 Jamison Ct Hagerstown, MD 21740-5185

To complete your deposit:
1. Send completed form to elcafoundation@elca.org and your Regional Gift Planner.
2. Print and mail completed form with your check.
3. Notify your Regional Gift Planner and elcafoundation@elca.org once your check has been mailed. Please include a tracking number if available.
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Form revised June 2021
ELCA Foundation • 8765 West Higgins Road • Chicago, IL 606311.
800.638.3522 or 773.380.2700 • elcafoundation@elca.org