Donations

Complete the following form to request a donation receipt to an individual or business/organization that has made a tax-deductible donation to the Merion Village Association.
RELATIONSHIP TO DONATION*
YOUR NAME*

First NameLast Name
YOUR E-MAIL ADDRESS*

Confirmation Emailexample@example.com
Was the Donation Made by an Individual or a Business / Organization?*

INDIVIDUALBUSINESS / ORGANIZATION
Donor Name*

First NameLast Name
Donor Business / Organization Name*
Donor Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Donor E-Mail Address*

Confirmation EmailWe'll send your receipt to this address
Date of Donation*

MonthDayYear
Date
Donation Type*

Item DonationMonetary DonationService DonationSponsorship
Summary of Item(s) Donated:*
Summary of Services Donated:*
Summary of Sponsorship:*
Total Value of Donation*
Use the $ symbol and decimal point is in this field (IE: $5.00)
I, the undersigned, certify under penalty of perjury under the laws of the United States of America that there were no goods or services provided as part of this donation. I further certify that all information provided in this request is complete and accurate.
SIGNATURE*

Clear
TITLE
Request Date*

MonthDayYear
Should be Empty: