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FILAM ARTS presents

Mail-in gift form


Gift information
Amount

Please charge my credit card VISA / MC / AE Acount Number CVV-code (3-4 digit number)

Enclosed is my check made payable to FilAm ARTS

Exp Date (Month/Year) Current Date

Signature for Card Holder

Donor information
Name on Card (print)

Corporate Affiliation (if applicable) Credit Card Billing Address City Contact Phone Number Contact Email Address Please send your check and this gift form to: Hope After Haiyan - FilAm ARTS c/o Rocio Nuyda P.O. Box 16594 5805 White Oak Avenue Encino, CA 91316 Your credit card statement will reflect the merchant name of FilAm ARTS/Hope After Haiyan. FilAm ARTS is a nonprofit 501(c)(3) organization. This gift is tax-deductible in the United States. A tax-deductible receipt is sent for each donation we receive. You will receive a paper receipt by mail. State Fax Zip