My signature below indicates that the information I have provided is accurate and truthful.
I acknowledge I am solely responsible for determining the personal tax deductibility of these expenses.
Click to upload a signature image, or leave blank for a signature line
PNG · JPG · transparent PNG recommended
Please send this completed form to:
Rebecca Keith | DeVault Alumni Center | 1000 E. 17th Street | Bloomington, IN 47408
Instructions
Click + Add Row to add a miles/points donation entry.
Default mile/point value is $0.015 each.
Click Save Draft to download a JSON file that preserves all entries, then Load Draft to restore the information. The exported file can be opened on any computer running this HTML file.