Hatzolah EMS | Request A Tax-deduction Receipt

Request A Tax-deduction Receipt

To request a receipt for a previous donation, please fill out your information below.
Items in red must be filled out.

Title(s)

First Name

Last Name

Mailing Address

City

State

Zip

Phone Number

Amount of Donation
$

Donation Type (choose one)
check credit card cash item of value*
*If item of value, describe in the comments section below.

Date of Donation

This Date Is (choose one)
exact approximate
Please note: year of donation must be correct.

Donation Sent By (choose one)

mail online

in person (name of person given to:)

I am Requesting a(n) (choose one)

duplicate (received a receipt but don't know where it is.)

original (never received a receipt.)

Comments or More Information

Please include a donation envelope.