Kansas Coalition Against Sexual and Domestic Violence, safety, accountability, and justice for victims of domestic violence and sexual assault and their children. Mail-in Donation Form

Print this form and mail it with your tax deductible donation in any amount to:

KCSDV
634 SW Harrison
Topeka, KS 66603


Name _____________________________________________________________________

Company / Organization ______________________________________________________

Address ___________________________________________________________________

City / State / Zip Code _______________________________________________________

Phone _______________________________ E-Mail _______________________________

My Company will make a Matching Gift (Y or N): __________

If Yes, Company Name: ______________________________________________________

Additional comments regarding this donation:

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

Enclosed please find my contribution of $____________ in support of the statewide effort to end sexual and domestic violence in Kansas.

Under IRS code, because no goods nor services were exchanged for your donation, you may deduct the full value of your gift as a charitable contribution to a qualified 501(c)(3) organization.

Thank you for your time and commitment to ending sexual and domestic violence.
You will receive a letter acknowledging your gift which you may use for tax purposes.