PENNSYLVANIA ASSOCIATION OF NUMISMATISTS
A Pennsylvania Non-Profit Corporation
Dedicated to the Study of Numismatics
YN PROGRAM DONATION FORM
Receipt and Inventory of Items Donated To P.A.N.
for the Coins For A's program.
Received from:
Name: _______________________________________________________
Street: _______________________________________________________
City: _________________________________________________________
State: _____________________________ Zip Code: ___________________
Phone: _____________________________
| Quantity
| Description
| Unit
| Value |
Receipt of the above items is acknowledged with thanks
the day of _______________.
_______________________________________________________________________
Authorized Officer's Signature
INSTRUCTIONS:
SEND THIS FORM TOGETHER WITH THE DONATED ITEMS
TO THE ADDRESS BELOW.
DO NOT SIGN IT.
WE WILL SIGN THE RECEIPT AND RETURN IT TO YOU.
THANK YOU!
P.A.N. COINS FOR A's PROGRAM
401 MEADOW STREET
CHESWICK, PA 15024
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