2024 Church Contribution Statement Request Form

2024 CHURCH CONTRIBUTION STATEMENT
If you have contributed more than $200 during 2024 and wish to receive a statement of your contributions suitable for income tax purposes, please complete this form.
List the full name under which you would prefer your statement to be issued:
Name*

First NameLast Name
If you used more than one name for your contributions, list other names under which contributions were made:
Other Names Used:

First NameLast Name
List Your Current Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Did you have a different address for any part of 2022? If so, please list your previous address.
Previous Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Date of Birth*
In case we have to contact you, please provide us with your email and phone numbers.
E-mail
example@example.com
Mobile Number*

Area CodePhone Number
Home Number

Area CodePhone Number
How would you like your statement delivered?*

EmailU.S. Postal ServiceIn-Person pick up
Privacy Policy Statement – Highland Church is committed to protecting personal data and respecting the rights of our data subjects (people whose personal data we collect and use). Highland Church values the personal information entrusted to us and we respect that trust, by complying with all relevant laws and adopting good practice. We process personal data to help us: 1. Maintain a list of our church members, maintain church accounts and records. (Click to see full policy statement)
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2024 CHURCH CONTRIBUTION STATEMENT

If you have contributed more than $200 during 2024 and wish to receive a statement of your contributions suitable for income tax purposes, please complete this form.