Philanthropist's Indulgence
This medal is distributed in Genuine quality to members of the 'Random Acts of TF2' subreddit, who partook in various events organized by the subreddit.
There are 1,946 known instances of this item in Genuine quality (and counting up).
Source
Genuine Philanthropist's Indulgence
Team Fortress 2 Level 1 Community Medal
A medal to recognize the generous gifters of the Random Acts of TF2 group
( Not Tradable or Marketable )