様式6(RECEIPT)

Donation Form Recipient name: Address: City: State/Province: Postal code: Phone: Type of organization: Total pledge amount: Type of donation: Description of donation: Quantity : Value of donation:  School District  Community College District  Non-profit Organization  Public Entity Recipient Signature Date Thank you for your Acceptance! Special Instructions: Recipient to provide letter of receipt on letterhead describing your organization as non-profit/tax exempt as defined in Section 509 (a) of the Internal Revenue Code. Disclaimer of Warranties: The item is donated subject to No Warranty from SMCCD to the Recipient and Recipient accepts the item in its present condition, as is with all faults, obvious and latent, as may be discovered at the time of the donation or subsequently. SMCCD does not warrant that the item is of merchantable quality or that it can be used for any particular purpose. Addresses: District Office 3401 CSM Drive San Mateo, CA 94402 College of San Mateo 1700 W.Hillsdale Blvd. San Mateo, CA 94402 Cañada College 4200 Farm Hill Boulevard, Redwood City, CA 94061 Skyline College 3300 College Drive San Bruno, CA 94066

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