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The document is a certification form for reporting gifts and pledges received by an organization, specifically for General Support Grants to State Humanities Councils. It includes sections for detailing donor categories, amounts given, and the use of matching funds. The certifying individual confirms that the reported amounts meet eligibility criteria set by the NEH and that documentation will be retained for three years. It also outlines the process for submitting the form and provides contact information for comments regarding the reporting burden.

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Click ‘Get Form’ to open the Certification of Gifts/Pledges form in our editor.
Begin by entering the FAIN and Report Number at the top of the form. This information is crucial for tracking your submission.
Fill in the Recipient Organization and Date Submitted fields accurately to ensure proper identification of your organization.
In the Donor Category section, input the number of donors and amounts given for each category: Individuals, Corporations, Foundations, etc. Make sure to total these amounts at the end.
If applicable, indicate whether documentation is attached for any pledges certified. This is important for compliance with grant requirements.
Complete the certification statement by confirming that all amounts have been received as gifts and meet eligibility criteria. Ensure you provide your name as the Institutional Grant Administrator.
Finally, print a copy for signature, scan it, and email it to grantmanagement@neh.gov as instructed.

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