Country Fair Donation Contract Is the item to be donated a personal or business item?* Personal Business Donor/Company Name* Authorized by* Address* Street Address City StateAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*FaxEmail* Item or Cash Donation*ItemDescriptionFair Market Value Estimate ItemGift CertificateCash Click "+" to add rows, click "-" to remove them. If applicable, please indicate quantity, size, color, brand, restrictions, exclusions, dates, etc. in the DescriptionTax Receipt* Yes (tax receipt will be mailed in November) No (decline tax receipt) Business Name*
