Lance Armstrong Foundation: Tax Receipt Request

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Tax Receipt Request Form

If you have made a donation to the Lance Armstrong and would like to receive a tax receipt acknowledging your gift, please completely fill out the following form.

* required information



First Name:*
Last Name:*
Organization/Company Name:
Email:*
Address Line 1:*
Address Line 2:
City:*
State:*
Province:
ZIP/Postal Code:*
Country:
Phone:
Fax:
Birth Date:*	(mm/dd/yyyy)
Gender:*	Female Male


Please include any other information that can help us identify your donation.
Amount of Donation:	$
Donation Date:	(mm/dd/yyyy)
Other name or business donation could be under:
Other address donation could be under:
How would you like to receive your receipt?:*	Fax E-Mail Postal Mail

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