LCC Foundation Gift Transmittal
Process Change: Deposits can no longer be sent via Campus Mail. Please deliver all deposits, in person, to
our office located in Building 19, Room 270. Deposits must be counted and this form must be signed by
Foundation staff before you leave our office.
This form is used to submit donations of cash, checks and credit cards to the LCC Foundation. Please attach all correspondence
from the donor and any additional paperwork as applicable. The LCC Foundation will mail a written acknowledgement / tax receipt
to the donor for the charitable contribution in accordance with IRS guidelines. Submit credit cards, cash and checks on
separate transmittals.
Date Department Contact
Description of Deposit:
Total of Deposit: $
Donor Name & Address: Type Fund # Amount Check/Credit Card#
*If listing credit cards, please include: billing address, expiration date and CVV code on back of card.
Submitted By Date
Received By Date
LCC Foundation
4/23/2015
4000 E 30th Avenue
Eugene, OR 97405
T 541.463.5135
Lanecc.edu/foundation