Landers Toyota

10825 Colonel Glenn Road
Little Rock, AR 72204

Sales: (888) 314-4350
Service: 501-568-5800

Donation Form

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Charitable Donation Request Form

Name of Soliciting Agency* Contact Name* Address* City* State* Postal Code* Best Phone* Fax Incorporated in What State?* Is there BHAS IRS granted tax-deductible status on gifts to you? Yes No Your Relationship to Agency: Employee Volunteer Broker Other Do you receive a percentage of the donation? If yes, what percentage?* Is this solicitaiton registered with the consumer affairs department? What City?* What amount are you requesting?* To what use will the donation be used?* Name of Parent Organization Parent Organization Address Parent Organization Phone Signature and Date*