Lugo Charities Inc.

2nd Annual Bike-In-A-Box

Please send this stub with your check made payable to: Bike-In-A-Box

Mail to: Bike In A Box

P.O. Box 26363
Tucson, AZ 85726

Amount $ ________________

Name _____________________________________________________

Business ___________________________________________________

Address ___________________________________________________

City _________________ State _________________ Zip ___________

Phone _____________________

Cut

Lugo Charities Inc.

nd
2 Annual Bike-In-A-Box
P.O. Box 26363
Tucson, AZ 85726
Non-Profit 501 (c) (3) organization # 01-0934333

Emerald - $1,350.00 buys 30 Bicycles ____

Diamond - $675.00 buys 15 Bicycles ____ Sapphire - $450.00 buys 10 Bicycles ____

Ruby - $225.00 buys 5 Bicycles ____ Topaz - $45.00 buys 1 Bicycle ____

Opal - Food & Other ____

We have received a charitable contribution from __________________________________ in the amount

of $ _____________ Date _____________ to support the 2nd Annual, Bike In A Box, sponsored by Lugo
Charities Inc. to benefit under privileged children on Sunday, December 19, 2010.

Retain this portion for your tax record.

Lugo Charities Inc will also mail you a receipt upon receiving your contribution

Thank you for your support!