Funds Received Submission
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Day
Year
Date
Payer Name
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If this payment came from a 3rd party (Schwab, Fidelity, The Donors Fund, etc.), please write in the notes section the account name that it should be applied to.
Address
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Payer Email
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Payment Type
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Check
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Amount Received
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Date Received
*
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Month
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Day
Year
Date
Check Date
*
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Month
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Day
Year
Date
Check #
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Designation
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Donation
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Notes/Context
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Form Submitted By
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