MATCHING GIFTS PROGRAM

At KODA Resources we care about our employees and our communities. We take pride in corporate employees who invest their time and money in philanthropic causes. The KODA Resources Matching Gifts Program helps employees make a greater financial contribution to their communities by allowing participants to double their monetary gifts to charitable 501(c)(3) organizations of their choice.

Once one of our employees receives approval for their contributions, a responsible financial officer of your organization must complete the form below and attach a copy of the donor's proof of monetary gifts and the organization's IRS 501(c)(3) verification.

For more information, please contact the Matching Gifts Program at gifts@kodares.com.

KODA Resources
Matching Gifts Application for Organizations

Organization Name

Federal Tax ID Number

Address

City

State

Zip

Contact Name

Contact Last Name

Contact Title

Contact Phone Number

Email

Date

File Upload

Provide proof of monetary gifts and copy of organization's IRS 501(c)(3) verification.

Drag files here or choose files

Donor Name

Donor Last Name

Gift Amount

Gift Date

Attestation

I CERTIFY THAT THE GIFT INDICATED HAS BEEN RECEIVED, AND IT WILL BE USED TO SUPPORT THE PRIMARY OBJECTIVES OF THE ORGANIZATION, WHICH IS CLASSIFIED AS A TAX-EXEMPT ORGANIZATION UNDER SECTION 501(C)(3) OF THE U.S. INTERNAL REVENUE CODE AND THAT: (A) THIS IS AN ELIGIBLE ORGANIZATION; (B) THE GIFT MEETS ALL THE REQUIREMENTS LISTED IN KODA RESOURCES MATCHING GIFTS GUIDELINES; AND (C) NEITHER KODA RESOURCES NOR THE EMPLOYEE RECEIVED GOOD, SERVICES OR OTHER QUID PRO QUO AS DEFINED IN THE RELEVANT IRS RULES AND REGULATIONS.

SUBMIT

In June of 2020, Middle Fork Energy Partners, LLC combined with KODA Resources. Middle Fork Energy Uinta, LLC and
Middle Fork Energy Holdings, LLC are now wholly owned subsidiaries of KODA Holdings, LLC.

MATCHING GIFTS PROGRAM

KODA ResourcesMatching Gifts Application for Organizations

In June of 2020, Middle Fork Energy Partners, LLC combined with KODA Resources. Middle Fork Energy Uinta, LLC and Middle Fork Energy Holdings, LLC are now wholly owned subsidiaries of KODA Holdings, LLC.

KODA Resources
Matching Gifts Application for Organizations

In June of 2020, Middle Fork Energy Partners, LLC combined with KODA Resources. Middle Fork Energy Uinta, LLC and
Middle Fork Energy Holdings, LLC are now wholly owned subsidiaries of KODA Holdings, LLC.