ELECTRIC AUTO ASSOCIATION (EAA) A California 501(c)(3) non-profit public benefit corporation Mailing address for donations: Electric Auto Association P.O. Box 639 Los Altos, CA 94023-0639 This form is to accompany donations by check or money order. We welcome your contribution, in any amount. The EAA is sincerely grateful for the generous support of our donors. Your assistance and support will help fulfill our mission. Your contribution is tax-deductible to the extent allowed by law. Contact your tax consultant for further information on this subject. See http://eaaev.org/eaadonationsfundlist.html for a list of currently open Special Funds, approved by the EAA Board of Directors. Donors may request that new Special Funds be established. Please send your request in writing to the address above, or by email: [email protected]. Each Special Fund must be approved by the EAA Board of Directors before contributions can be accepted specifically designated for that Special Fund. If you wish your contribution to remain anonymous (known only to the EAA Board of Directors), please check here /__/. Name ________________________________ Address _____________________________ City, State, ZIP __________________________ Phone ________________________ E-mail address __________________________ Amount of contribution enclosed $___________ Amount pledged for future donations -- total $________________ To be paid in ____ (number) installments /_/ monthly or /_/ quarterly of $__________ each. Check here /_/ if this donation is to the EAA General Fund, to be used for normal EAA operations, or for such other purposes as the EAA Board of Directors shall deem appropriate. OR -- enter the number and name of the Special Fund for which this donation is earmarked: Fund Number:_____________ Name:___________________________ ================= Rev 1.0 10/24/02