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[]
[null," Texas Division Sons of Confederate Veterans Donation Receipt"]
[null,"mail to:"]
[null," Granvel J. Block, Texas Div. Cmdr."]
[null,"1604 Buckingham Dr."]
[null,"Orange, Texas 77632"]
[null,"make checks payable to \"Texas Division - SCV\""]
[null,null,"Donor name"]
[null,null,"Address"]
[null,null,"City"]
[null,null,"State/Province"]
[null,null,"Postal code"]
[null,null,"Phone"]
[null,null,"Total pledge amount",50]
[null,null,null,"4x8 Brick, 3 Lines, 18 Charactors per line (Maximum)"]
[null,null,"Line #1"]
[null,null,"Line #2"]
[null,null,"Line #3"]
[null,null,null," "]
[null,null,"Type of donation"," Cash"]
[null,null,"Description ","\"Texas Division-SCV\"   Confederate Memorial Fund"]
[null,null,"Value ",50]
[]
[null,"Thank you for your 501C3 Deductable Donation."]