Donation/Charity Request Form

If your program meets the criteria for the Charity Cost Program, please fill out the following
form at least 60 days prior to your event. Please make your request as complete as possible.
You will receive a response within 30 days of your request.

Date of Request

(MM/DD/YY)

Date of Event

(MM/DD/YY)

Organization

Event

Contact Person

Street Address

City

Zip Code

Phone Number

(XXX) XXX-XXXX

Contact Persons E-mail

Organization's Website

In order for Marty's to waive sales tax, I/We will be required to provide a Sales Tax Exemption Certificate

Yes

Our organization is a non-profit organization

Yes

Please describe your organization's purpose and mission

How will the Charity Cost Program enhance the mission of your organization?

Please describe what type of item you are requesting -Please indicate what type(s) of products you are looking to purchase (bicycles, Bicycle accessories, etc)

Please give us any additional information that would be relevant to this request

Donation/Charity Request Form

Randolph

Morristown

Hackettstown

East Hanover

High Bridge