S0S Footwear 2011 _revised__eng._ -

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					                        “S.O.S. Footwear Donation Program” - 2011

        YES . we wish to contribute to the Two/Ten Foundation’s 2011 Footwear Donation Campaign” to collect footwear for charitable
         organizations by donating the following footwear (state approx. number of pairs):

Men’s & Boys’               ____________________ pairs                  True & fair market value (*)        $ ___________________
Women’s & Girls’            _____________________ pairs                 True & fair market value (*)        $ ___________________
Children’s & Infants’       _____________________ pairs                 True & fair market value (*)        $ ___________________
Safety footwear:            _____________________pairs                  True & fair market value (*)        $___________________
Total pairage:              _____________________                       Total value                         $___________________
(*) – Please note that starting this year, all donations of footwear valued at more than $1,000. and for which a tax receipt is required will
be subject to an independent evaluation (see letter enclosed). “Fair market value” (FMV) is described by Revenue Canada as the highest
price obtainable in an open and unrestricted market between informed and prudent parties, acting at arm’s length, under no compulsion to
act, expressed in terms of money, or money’s worth”.

An official income tax receipt will be issued for the total value, if required.                             Receipt required :   □
         NOTE:      All footwear should be shipped prepaid. Packing slips should be supplied and cartons properly identified
         “Two/Ten SOS Footwear Donation Program”. To facilitate warehouse storage, pallets should be kept to the
         following dimensions: 40” x 48” x 48” high, shrink-wrapped and clearly labelled.
         To help out with the sorting of the goods, it would be highly appreciated by the Two/Ten volunteers if you would
         indicate on the outer carton the contents (i.e. 15 pairs men’s winter boots ….. 18 pairs of girls’ dress shoes, etc.
The donated footwear will only be used for our charitable purpose and will not be bartered or sold

We are shipping footwear to the Two/Ten warehousing location indicated below ( check location). If shipping to more than one
location, please indicate approximate pairage being shipped at each location. (This will help us determine the quantity available for
distribution in the various areas).

Name of Contact: _____________________________________                       Signature: __________________________________
                                                                                                (signature required for receipt)
Company _________________________________________________________________________________________
Telephone: _______________________ Fax_______________________ E-mail: ______________________________

   Toronto: Two/Ten Foundation “S0S Footwear” Schenker Canada Limited, c/o LDI Warehouse, 550 Industrial Road,
             Milton, Ontario L9T 5A6(Delivery contact: Karen Rawn, Tel. 905-673-0807, ext.312561 to confirm
             number of skids or cartons to be donated and estimated time of arrival at warehouse. (Please call before delivery)

□ Montreal: Two/Ten Foundation “S0S Footwear”, c/o M&M Footwear Inc., 4350 boul. Thimens, St. Laurent, QC H4R 2P2
                   Tel. (514) 738-8210. Delivery contact: Nasser: 514-738-8210) Due to space constraints, deliveries must be
                   made after November 22 and no later than December 5

   Quebec         Two/Ten Foundation “S0S Footwear”, c/o Jean-Paul Fortin (1997) Inc. (Attn: François Monat)
                   2050 des Celles, Québec, QC G1C 1X8 Tel. (418) 845-5369 – Fax (418) 845-5457

   Vancouver: Two/Ten Foundation “S0S Footwear”, c/o Ronsons Shoe Stores Ltd. (Attn: Jamie Taite),
                12495 Horseshoe Way, Richmond, B.C. V7A 4X6 Tel.(604) 270-9974 (Please call before delivery)

   Winnipeg :          Two/Ten Foundation “S0S Footwear”, c/o Canadian Footwear Ltd. (Attn: Ash – ext. 210),
                        128 Adelaide St., Winnipeg, MB R3A 0W5 Tel. (204) 944-7463 ( call before shipping )

For further information, contact the Foundation’s office.
                   Two/Ten Foundation of Canada, P.O. Box 306 – Westmount Station, Montreal, QC H3Z 2T5
                          Tel. (450) 671-3604 – Fax (450) 671-0166 e-mail:
             “SOS Footwear Donation” Program - 2011

Name of donor: ___________________________________________

To facilitate the sorting of the footwear by the Two/Ten volunteers, please affix
label on each box to indicate its content.

Gender                         Type of footwear                        Pairs

□     MEN’S                    _______________                         ______

□     WOMEN’S                  _______________                         ______

□     CHILDREN’S               _______________                         ______

       Thank you for your generosity and kindness

(Please photocopy as needed)

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