Free DonationForm - Indiana

INDIANA NONGAME FUND DONATION
State Form 50883 (R / 1-05) Form approved by State Board of Accounts, 2005

Indiana Nongame Fund
Mail the completed form below and your contribution in the form of check or money order payable to the Indiana Nongame Fund. Indiana Nongame Fund Division of Fish and Wildlife 402 W. Washington St., W273 Indianapolis, IN 46204

I (We) wish to donate $

to the Indiana Nongame Wildlife Fund.

By checking this box I/we request nondisclosure of my/our identity as a donor of a gift made to a public agency, pursuant to IC 5-14-3-4.

Name(s) Address City E-mail address
The Wildlife Diversity Section is funded almost exclusively by contributions to the Indiana Nongame Fund. Voluntary contributions to the Nongame Fund are tax-deductible under Federal Revenue Code Title 26, 170 c1. The Wildlife Diversity Section is an entity of the State of Indiana in the Division of Fish and Wildlife with the Department of Natural Resources.

State

Zip Code