Charitable Project Funds - Withdrawal Request
Account Name
Account Number
Project Name/ID
(optional)
First / Last name
Title
Email address
Phone number
Withdrawal Request Amount
CAD
Funds Required By
MM
/
DD
/
YYYY
Special Instructions
Use of Funds
Provide as much detail as possible and upload supporting documents (quotes, receipts, authorized budget, etc.)
In signing this request, I confirm that the funds received will be used solely for the provision of charitable goods and services as described in
Use of Funds
under the terms of any agreement entered into with The Veritas Foundation. I also confirm that no personal taxable benefit will be received by myself or any other individual other than that which is necessary, reasonable, and proportionate to the public benefit that is being delivered.
Authorized Signature
Clear
Date
04
/
04
/
2025
File / Image upload
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Verification
SUBMIT FORM
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