Matching Gift Form

Koch Foundation.
10 South 11th Avenue
Evansville, IN 47712

Phone: (812) 465-9678

First Name *

Last Name *

Address *

City *

State *

Zip Code *

Your email address *

Date of Employment *

Company *

Company Location *

Employment Status *

Date of Donation *

Year

Month

Day

Match up to * $

Of my personal gift of * $

Federal Tax ID Number for the Nonprofit *

Please provide the IRS number assigned to the nonprofit verifying its 501(c)(3) status. It is often referred to as an EIN and is a 9-digit number displayed in the following format: xx-xxxxxxx. It is usually found on the receipt you receive from the charity.

Nonprofit Name *

Nonprofit Address *

Nonprofit City *

Nonprofit State *

Nonprofit Zip Code *

Specific instructions for your match

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Donation Receipt

Files must be less than 8 MB.
Allowed file types: gif jpg jpeg png pdf.

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