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IRA-QCD Notification Form Copy

American Red Cross

Name * First Last
IRA Custodian *
If 'Other', please indicate your IRA Custodian below:
Your Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Your Email Address
Gift Date MM / DD / YYYY
Gift Amount *
Gift Designation *
Do Not Fill This Out

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