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["FUND NAME:"]
[]
["EVENT NAME:",{"$nulls":6},"Date to HCCF:  "]
[]
["List checks below with any gift"]
["amount and non-gift amount from",null,null,null,"List CASH donations below with name and contact information along with gift amount and any non-gift amount from goods/services received."]
[" goods or services received."]
["Checks",null,null,null,"Enter Cash Amount - provide address if donation acknowledgment is required"]
["Check #"," Financial Gift Amount","Value Received",null,"Name","Address","City, State Zip","email"," Financial Gift Amount","Value Received"]
{"$rows_empty":29}
[null,0,0,null,"HCCF Received by:",null,null,null,0,0]
[]
["Grand Total:",0,0,null,"For HCCF Deposit on:"]
[]
[{"$nulls":5},"Fund Rep Comments:"]