Internal Phone Credit Card Processing Form

Donor Name

Name

First Last

Donor Address

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Reason for Address Change

Recently moved

Salesforce

“Have you donated to us before?”

IF YES: “Great! Give me a moment to lookup your contact.”

Look up donor ACCOUNT in Salesforce using name and address. If you can confirm an exact match of their name and address, then fill in the 6 digit NEW ORTL ID.

New ORTL ID from Salesforce

IF NEW DONOR: “Great! Let me get some basic information from you.”

Fill in the following fields for new donors or confirm existing information that is in Salesforce with existing donors:

Phone

Email

Check if

No email address

What prompted this donation?

Other

Employer Information

State law requires us to request the following employer information.

Employment Information

I am employed
I am retired
I am a homemaker or unemployed
Refused

Occupation

Employer

Employer City

Tax Information

Let the donor know they may qualify for the Oregon Political Tax Credit. Single filers with federal adjusted gross incomes over $100,000 or joint filers with combined adjusted gross incomes exceeding $200,000 no longer qualify for the Oregon Political Tax Credit.

I intend to

Single-file my taxes
Joint-file my taxes

Spouse Name

First Last

Spouse Employment Information

My spouse is employed
My spouse is retired
My spouse is a homemaker or unemployed
Refused

Spouse Occupation

Spouse Employer

Spouse Employer City

Payment

Donation Amount

Donation Type

Make this a Monthly Gift

Donation Total

$0.00

Credit Card

American Express

Discover

MasterCard

Visa

Card Number Expiration Date Security Code Cardholder Name

Misc.

ORTL Staff Person Who Completed this Form

Notes

OFFICE USE ONLY