GIFT TO QUALIFIED DONEE FORM
Fill this form if you are providing a gift to a Canadian registered charity
Date
*
-
Month
-
Day
Year
Date
Name of the Organization
*
Registration Number - Federal
*
Registration Number - Provincial
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Website
*
Enter a URL
Primary Contact
*
First Name
Last Name
Position
Phone Number
Please enter a valid phone number.
Email
example@example.com
Charitable Purpose/Activities to serve with this donation amount
*
Amount Approved
*
Approved by
*
Approver Email (CFO)
*
example@humanconcern.org
Signed by
*
Signer Email (CEO)
*
example@humanconcern.org
Submitted by
*
Submitter Email
*
example@humanconcern.org
T3010 Registered Charity Information
*
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