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Please fill out the following information about your property.

Providing this information enables us to process your donation as efficiently as possible.

DONOR INFO

Full Name*

Phone

Email Address*

Message*

Address

City

State

Zip

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PROPERTY INFO

Property Owners Name*

Address or block and lot *

APN or Pin Number (if available)

City*

State

Zip*

Type of Property*

Single FamilyCommerciaLMobile HomeRVLotOther

Property Taxes (approximate) $*

Association fees $*

Is there a mortgage or lien on property?*

YesNo

Have you tried selling the property?*

YesNo

Is the property occupied?*

YesNo

Are utilities connected to the property?:*

YesNo

Where did you hear about us?*

Broker RealtorDonated BeforeEmailFriend/RelativeGoogleMSN/BINGOtherPostcardRadioYahoo

Additional Comments:*

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My Small Business, LLC.

Loving Paws, Inc. is a 501(c)(3) nonprofit organization.

Donations can be sent to: PO Box 307 • Lake Grove,

NY • 11755