Tax Contribution Request Please complete this form to request your year-end tax contribution report. Year-End Tax Contribution Request Your Name* First Last Please enter your first and last nameYour Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Please enter your full street addressHome Phone NumberMobile Phone Number*Email Type of Statement* Individual Joint Please choose whether this request is for an individual or joint statementSpouse's Name First Last Please enter your spouse’s name that should appear on the joint statementCAPTCHANameThis field is for validation purposes and should be left unchanged.