Donation Request Form

 

Due to the high demand for donations we ask that you please fill out the form below and email the filled in form to invader_grrr@hotmail.com. Please allow a few days for review. At this time donations will be pulled from available inventory only. Commissions are currently not available for donations.

 

 

 

 

501(c)(3) ORGANIZATION DONATION RECEIPT

 

Name of Non-Profit Organization: _______________________________________  

 

Shipping Address for Donation: ______________________________________________________

______________________________________________________________________

______________________________________________________________________ 

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______________________________________________________________________

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EIN: ___________________________________________ 

 

 

Donor Information( to be filled in by Black Canvas LLC )

Donor’s Name: __________________________________________________________

   

Donor’s Address: ________________________________________________________

________________________________________________________________________

________________________________________________________________________

Donation Information:

 

Thank you for your donation with a value of ___________________________ Dollars ($_____________), made to the above-mentioned 501(c)(3) Non-Profit Organization.

Donation Description: ________________________________________________________________________

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Requesting Representative’s Signature _____________________________________    

Requesting Representative’s Name ___________________________________________________

Title: _________________________ Date: __________________