Eliot Society Benefits Request Form

As an expression of our appreciation, the William Greenleaf Eliot Society is pleased to offer you a variety of membership privileges. Please note, however, the IRS requires that the deductible amount of your gift must be reduced by the aggregate fair market value of all benefits you choose to accept even if you do not use them. You are allowed to take benefits of up to 2% of your total gift or $113.00, whichever is less, without being required by the IRS to reduce your gift deduction. These regulations apply only to U.S. Federal Income Taxes.

Please review the fair market value listed for each benefit below and indicate your choice(s) by checking the appropriate box(es). You may choose to decline all benefits that hold substantial fair market value.

We assume you decline all benefits unless you specifically request them.

Your Full Name

Any additional members full names

Address

City

State/Province

Zip/Postal

Country

Declining fair market value benefits

I/We decline all benefits that have substantial fair market value

Available Benefits

Whittemore House Application

Application to join the Faculty Conference Center at Whittemore House. Membership fee charged.

Fair Market Value = $0

University Libraries

Eliot Society membership card for privileges while on the Danforth Campus and at any of the libraries within the University Libraries system. Please visit the circulation desk at the John M. Olin Library for access. (Law Library privileges are limited to Law Eliot Society members and alumni.)

Fair Market Value = $0

Sumers Recreation Center Access

Unlimited Sumers Recreation Center Access

Unlimited Sumers Recreation Center Access for Faculty/Staff (Spouse/Partner membership available if faculty/staff member has membership.)

Fair Market Value of Center Access = $400; Fair Market Value of Center Access for Faculty/ Staff = $200; Fair Market Value of Visitor Pass = $10

Danforth Campus Parking Permits

FACULTY/STAFF Danforth Campus Parking Permit Voucher (Limit one per family. Value not to exceed a maximum fair market value of $500)

STUDENT Danforth Campus Parking Permit Voucher (Limit one per family. Available to sophomores, juniors, seniors, and graduate students only. Value not to exceed a maximum fair market value of $500)

ELIOT SOCIETY TEMPORARY Parking Access (Complimentary) Valid for access to visitor garages.

ELIOT SOCIETY VISITOR Parking Permit (Complimentary) Valid in visitor designated spaces in visitor garages only

Employee ID Number

Student Name

Student ID Number

Car Information for Eliot Society Visitor Parking Permit

First Eliot member name

Car #1 Make

Car #1 Color

License Plate Number

State

Second Eliot member name

Car #2 Make

Car #2 Color

License Plate Number

State

You are required to have a zone assignment through Parking & Transportation in order to receive a daily-use permit. If you select the parking benefit, you will be issued an Eliot Society voucher to present to Parking & Transportation. The Eliot Society voucher can be applied toward the cost of your daily-use parking permit. The Eliot Society voucher may not apply to every permit type.

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