Please fill out this form to request a Donor Acknowledgement Letter for Tax purposes sent to a donor.
Full Name of person that donated
*
Prefix
First Name
Last Name
Suffix
Company name if donated by a Business or Organization
Which OCB location was the donation given to?
*
Crown Point, IN
Tallassee, Alabama
Other
Date of donation
*
-
Year
-
Month
Day
Date
Monetary donation?
*
Yes
No
Monetary value or US dollar amount given
*
Name of the person working for OCB that the donation was given to
*
Prefix
First Name
Last Name
Suffix
Address that the tax form is to be sent to
*
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Email of the person receiving the tax form
*
example@example.com
Phone Number of the person receiving the tax form
*
-
Area Code
Phone Number
Describe the item that was donated needing tax form
*
Upload any supporting documents or photos of donation here
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