Kirkland Printable Donor Form
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I WANT TO HELP SAVE THE KIRKLAND!
Yes, Im interested in aiding RUPCOs mission to revitalize the Kirkland Building.
All donations in any amount are completely tax-deductible. An added incentive for contributions of $500 or more to the Kirkland Fund is the option of taking a 25% NYS income tax credit for donors based on the amount given in place of a deduction.
| YOUR INFORMATION |
| Enclosed is my tax-deductible contribution of: |
In addition to my contribution, I would also like to purchase a limited edition etching:
$175.00 (unframed) $225.00 (framed) |
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Name:
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Street:
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| City: |
| State: |
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Zip:
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| Phone (day): |
| Phone (evening): |
| e-mail address: |
| How do you wish your name to be listed for donor recognition: |
I wish to remain anonymous. |
| MATCHING GIFT INFORMATION (Fill out this section only if you are eligible for a matching gift from your employer.) |
| I/we are eligible for a matching gift from my/our employer. |
| Name of employer: |
| SPREADING OUT YOUR CONTRIBUTION OVER TIME (Fill out this section only if you would like to donate over a specific time period.) |
I wish to spread my contribution out over 1, 2, or 3 years (min. donation of $500) |
Send me a reminder: Quarterly, Semiannually, or Annually |
| PAYMENT METHOD |
| Make checks payable to: RUPCO - Kirkland Fund |
Please charge my gift of $________________ to the following credit card: MasterCard or Visa |
| Card #: |
| Signature: |
| HONOR AND MEMORIAL GIFTS |
| This gift is in memory/honor of: |
| Please acknowledge the memorial gift (but not the amount) to: |
| Name: |
| Address: |
Mail to: Rural Ulster Preservation Company, 289 Fair Street, Kingston, NY 12401.
Thank you for supporting RUPCO.
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