1) Reporting date (please use mm/dd/yy format)Format: 99/99/992) What is the name of the organization that received these charitable IRA distributions?3) In what state is the organization located? AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareD.C.FloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingCanada4) Please enter your five digit ZIP code. (This information allows us to report results for specific Congressional districts.)5) Please select a general category for your organization.Public University Private University Small College Community/Junior College Technical School Academy/Secondary School Hospital/Health Care Organization Religious Organization Social Services Organization Environmental Group Community Foundation Museum, Symphony, Arts/Cultural Organization Private/Family Foundation Association Other (please specify) If you selected other, please specify:6) How many IRA distributions did your organization receive since passage of the Emergency Economic Stabilization Act on October 6, 2008, or since your last response to this survey? 1234567891011121314151617181920more than 207) What is the total amount of IRA distributions reported in question 6? Please provide a numeric answer in dollars (round to eliminate cents)--for example, if the total is $5,000, do not abbreviate to $5K. Please check your answer before submitting the survey. Typographical errors in this field will prevent your total from being included in a national total.$8) Please select the range that includes the AVERAGE amount of distributions reported in question 6.$1,000 or less $1,001 to $5,000 $5,001 to $10,000 $10,001 to $25,000 $25,001 to $50,000 $50,001 to $75,000 $75,001 to $100,000 9) Please select the range that includes the MEDIAN distribution amount of distributions reported in question 6 (the amount with an equal number of distributions below it and above it).$1,000 or less $1,001 to $5,000 $5,001 to $10,000 $10,001 to $25,000 $25,001 to $50,000 $50,001 to $75,000 $75,001 to $100,000 10) If you are willing to discuss your experience with IRA charitable rollovers with NCPG leaders and/or legislators, please provide your name, the name of your organization, and your e-mail address. Please provide this data the first time you respond to the survey ONLY. There is no need to re-enter it when you use the survey to report future distributions.