TipTap Donation Tax Receipt Request Form

tiptap Tax Receipt Form

You have to fill out this form only once, unless you change your donation card.
Esta forma solo se llena una sola vez, a menos que cambie de tarjeta.

Please enable JavaScript in your browser to complete this form.

First Name / Nombre (Required)

Last Name / Apellido (Required)

Address / Direccion (Required)

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Phone Number / Telefono (Required)

la of Card

Email Address / Correo Electronico (Required)

Date of Donation / Fecha De Donacion (Required)

Last 4 Digits of Card / Ultimos 4 Digitos de la Tarjeta (Required)

Amount / Cantidad (Required)

Part of the hispanic community?

check the box if you are part of the Hispanic Ministry.
Haz click aqui si formas parte del Ministerio Hispano.