Covenant Charitable Contribution Declaration

Please print and complete this form and return to the address below along with your contribution via check.

Name:

....................................................................................................................

Address:

....................................................................................................................

....................................................................................................................

....................................................................................................................

Postal code:

....................................................................

Telephone:

....................................................................

Email:

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I enclose a check made payable to 'Covenant' for $ ..................


Signed: ....................................................................................... Date: .............................


Please return to:
Mr. Craig Uffman
c/o St. Anne's Church
424 W. Market Street
Warsaw, IN
46580