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STATUTORY DECLARATION FOR DONATION This form is required for all Donations In Alberta exceeding 5 000. 00 Out of Alberta but within Canada exceeding 5 000. 00 or Out of Canada exceeding 1 000. 00. Applicant Donor Group AGLC ID Street Address City/Town/Village President s Name please print Postal Code President signature I Treasurer s Name please print Treasurer signature do solemnly declare that President OR Treasurer for the Donor Group 1.

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