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ACKNOWLEDGEMENT OF 1999 CONTRIBUTION/DONATION <br />FROM <br />SOUTHWESTERN BELL <br />NOTE: To sad* ZRS requirements, elective January 1,1994, this or a similar, form must be <br />completed for all comoibudons/donadons of $250 or more. Please attach this acknowledgment to <br />pour letterhead and return to the address indicated at the bottom ofthis forge. <br />Name and address of organization receiving the contribution/donation: <br />City of La Porte <br />P. 0. Box 1115 <br />La Porte, Texas 77572-1115 <br />Check Number: 3032639594 <br />Check Date: 10/ 12/ 1999 <br />For CASH contribution, please enter the dollar amount of the actual contribution. The value of <br />goods/or services; i.e., tickets, meals, golf spots, etc., should not be included in this total. <br />$ 5,000.00 <br />If applicable, please enter the value of GOODS AND/OR SERVICES received by Southwestern Bell. <br />Recognition of Southwestern Bell in a program, signage at an event, etc., are not considered "of <br />value" by the IRS. <br />For donated EQUIPMENT OR PROPERTY, please provide a description. <br />Signature• <br />Title: City Manager <br />Date: <br />Please return to: <br />Della Medloek <br />Southwestern Bell 'Telephone <br />308 S. Akardl, Room 1110 <br />Dallas, TX 95202-5399 <br />11/22/1999 <br />