Donation Request

Organization Information:

Organization Name

Address

City / State / Zip

Phone

Website

Tax Status

Tax Status:

Is your organization a registered 501(c)(3) nonprofit? Yes No

If Yes, EIN (Tax ID Number)

Organization Type

If Other, Kindly Specify

Are donations tax deductible? Yes No

Please attach:

IRS Determination Letter

W-9 Form

Contact Person:

Contact Person Name

Title / Role

Phone

Donation Request:

Type of Donation Requested

Amount or Item Requested

How Will This Donation Be Used?

How Will Our Dealership Be Recognized?

Past Support

Have we supported your organization before?

Yes No

If Yes, Please Describe

Attachments:

Please Include:

Proof of Nonprofit / Tax-Exempt Status

IRS Determination Letter

W-9 Form

Event Flyer / Brochure

Event/Program Information:

Name of Event / Program

Date(s) of Event

Location

Estimated Attendance

Purpose / Goal of Event