Taco Bell Foundation For Teens Mail-In Donation Form Enclosed is my gift of: _____$25 _____$50 _____$100 _____$500 _____$1,000 _____Other $______ Donor Name: _________________________________________________________________ Address: _____________________________________________ Unit #: _________________ City: ________________________________ State: __________ Zip Code: _______________ Phone: (______) ______ - _______ Email:___________________________________ Charge my credit card: _____MasterCard _____Visa _____American Express _____Discover Is this a company credit card? _____ yes _____no If yes, company name: ___________________________________________________________ Name as shown on card: _________________________________________________________ Card Number: ____________________________________________ Exp Date: _____________ Signature: _____________________________________________________________________ If paying by check, please make your check payable to Taco Bell Foundation for Teens. Please fill out this form and mail, with donation, to: Taco Bell Foundation for Teens Attn: Coordinator 1 Glen Bell Way Irvine, CA 92618 Taco Bell Foundation, Inc., also known as the Taco Bell Foundation For Teens, is a 501(c)(3) not-for-profit public benefit corporation. Federal Tax ID 33.0523542. Contributions to the Taco Bell Foundation are tax deductible to the full extent allowed by law. Questions? Please email us at tacobellfoundationforteens@tacobell.com.