Oxbow, Inc

Honorarium or Memorial Form

Print this form, fill in the information and mail it, with your check, to:

Oxbow, Inc.
P.O. Box 4172
Lawrenceburg , IN 47025

Oxbow, Inc sincerely thanks you for your donation which will help preserve

and improve wildlife habitat and protect a unique local wetland area.

My Gift is:

In memory of _____________________________________________________

In honor of (person) _______________________________________________

(occasion) _______________________________________________________

Oxbow, Inc. will acknowledge your gift by sending an appropriate note to those you designate. The amount of your gift will not be mentioned.

Please Notify: ______________________________________________________

Address: __________________________________________________________

City _______________________________ State _________ Zip ____________

From _____________________________________________________________

Address __________________________________________________________

City ________________________________ State _________ Zip ___________

Phone: ( ) _______________________ Amount of my gift: $ ___________

Please make your check payable to Oxbow, Inc.

Thank You – Your gift is tax deductible

Make a copy of this form for your records. As prescribed by tax law,

Oxbow, Inc. will formally acknowledge any donation of $250 or more.