Shelter Donation Request

To register your shelter for our program we require your tax determination form (501c3) and a noncash charitable contributions tax form (8283) that is then to be returned to us.

Litter Donation Request Application
To register your shelter for our program we require your tax determination form (501c3) and a noncash charitable contributions tax form (8283) that is then to be returned to us.
SHELTER/RESCUE INFORMATION
Shelter/Rescue Name*
EIN (Employer Identification Number)*
Primary Account Contact*
First Last
Primary Contact Email*
Primary Contact Phone*
Physical Address of Shelter/Rescue*
Street Address Address Line 2 City State ZIP Code
Website
Tax Determination Letter (501c3)*
Accepted file types: pdf, docx, jpg, png, Max. file size: 100 MB.
Please download and fill out ONLY Section A. 1a. and Section IV on page 2 of Tax Form 8283 (name, address, signature, etc.).

Attach completed form to application under 8283 Tax Form.
8283 Tax Form*
Accepted file types: pdf, docx, jpg, png, Max. file size: 100 MB.
Information for Donation Delivery
DOCK ACCESS AND FORKLIFT ARE REQUIRED FOR DELIVERY.
Name of Business that Will be Accepting Shipment*
*If your location does not have a dock to receive your shipment, please coordinate with a local business with one (such as PetSmart)*
Commercial DELIVERY Address*
Street Address Address Line 2 City State ZIP Code

*If your location does not have a dock to receive your shipment, please coordinate with a local business with one (such as PetSmart)*
Contact Name for Delivery*
First Last
Contact Phone for Delivery*
Shipment Confirmation Email*
Will the contact name and phone listed above be able to schedule an appointment with delivery driver?*
- Yes
- No
Do you have a pallet jack or forklift?*
*A Pallet Jack or a forklift is a requirement for delivery!
- Yes
- No
Do you have access to a Dock to Dock delivery?*
*Dock Access is a requirement for delivery! Dock height MUST be between 48-52 inches.
- Yes
- No
When was your last litter delivery?
Donations can be requested every 3 months (no exceptions).
MM slash DD slash YYYY
Delivery Terms*
Donation orders will take approximately 3-4 weeks from the time the order is placed to transit time. Driver will contact via phone 24-48 hours in advance of delivery to arrange an appointment. I understand that delivery will arrive via commercial truck and they can only deliver to a commercial address. Address cannot be changed after request is submitted. Dock to dock delivery and/or a forklift is required. Please agree to these terms by initialing here:
Acknowledgement of Contents*
Donation orders contain:
- 1 Pallet (49 bags) of Ultra Litter 40lb Bags (shelter use ONLY)
- 1 Pallet (90 boxes) of Cat Attract 20lb Boxes (Adopting Family to receive 1 free box with Cat Adoption)
Please acknowledge by initialing here:
Signature
I agree to the above terms and understand the responsibilities of this application*
Signature Date
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Litter Donation Request Application

SHELTER/RESCUE INFORMATION

Information for Donation Delivery

Signature

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