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Donations via Check

SAMPLE FORM

General Donations: The Gifts given via the General Donations forms below are all IRS tax deductible under Charitable Contributions to the extent allowed by law. In early January, you will receive a summarized list of all your Donations for the previous tax year that you can file with your taxes. Any tax questions, please check with your tax consultant.

Please send your checks to:

Non-Profit Name
Hwy 66
Kingman, AZ 86401

Name

First Name

Last Name

Organization/Employer

Enter if this is a gift from an Organization and you are the contact.

Verify Email

Address

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

Phone

Check Number

Insert the Check Number for tracking purposes.

Donation Amount?

Gift Note: