HSWAGATA BUDDHA TOOTH RELICS PRESERVATION MUSEUM
CASH DONATION RECEIPT FORM
Form Code: HSW-F26
1. RECEIPT DETAILS
1.1 Receipt Number: ______________________________
1.2 Date: ____ / ____ / ______
1.3 Time (optional): ___________
2. DONOR DETAILS
2.1 Donor Name:
[ ] Name: _________________________________
[ ] Anonymous donor (tick if requested)
2.2 Address (optional):
___________________________________________
___________________________________________
2.3 Phone / Email (optional):
___________________________________________
3. DONATION DETAILS
3.1 Amount (figures): __________________________
3.2 Amount (in words):
___________________________________________
3.3 Currency: _________________________________
3.4 Purpose of Donation:
[ ] General support
[ ] Relic care
[ ] Building / renovation
[ ] Education / outreach
[ ] Other: ________________________________
4. PAYMENT METHOD
[ ] Cash
[ ] Cheque / money order (No: ____________________)
[ ] Other: _____________________________________
5. OFFICE USE
5.1 Received By (name): _________________________
5.2 Department: ________________________________
5.3 Signature: _______________ Date: ____/____/____
6. THANK-YOU MESSAGE
(Short note to donor)
________________________________________________
________________________________________________