Buyer

Please complete all required sections of this Donation Form
(indicated by the asterisk*) and print clearly.

DONOR INFORMATION:

*First name:
*Last name:
*Address:

*City:
*ZIP:
*State:

*Email:
*Phone:

DONEE INFORMATION:

*Donee Name(a non-profit organization):

Donee Address(to be completed by RingAid):

Donee EIN(to be completed by RingAid):

DONATION DESCRIPTION:

*Please provide a brief description of the jewelry you wish to donate (the “Jewelry”):

*Estimated Value($):

PURCHASER INFORMATION:

Purchaser Name: Pacific Gemological Laboratory, Inc

Purchaser Address: 534 Southwest 3rd Avenue, Suite 206, Portland OR 97204

DONATION COMMITMENT:

Donor hereby authorizes RingAid, on behalf of Donor, to sell the Jewelry to Purchaser at a price equal to the Jewelry’s appraised value, as agreed between RingAid and Purchaser, and authorizes RingAid, on behalf of Donor, to donate all such sale proceeds to Donee.

*Donor Signature

*Date:

Unless other delivery arrangements are agreed please mail this Donation Form and the accompanying Jewelry to the Purchaser’s address above. RingAid will contact you upon receipt.

www.ringaid.org | PO Box 2084, Tualatin, OR 97062 | (971) 808-3799 | contact@ringaid.org

Donate with your heart without paying money.