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創世基金會 【捐款資訊不公開聲明書】回覆表單
本人不願公開姓名(名稱)及捐款金額，特依據財團法人法第25條第3項第2款但書規定提出此聲明書，請貴會依法辦理
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我不同意公開捐款資訊
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本人不願公開姓名(名稱)及捐款金額
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立書人(捐助人)-不同捐助人需分開填寫
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捐助人身份證字號/統一編號
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法定代理人/監護人
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捐款收據編號(可致電02-2835-7700確認)
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聯絡地址：
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聯絡電話：
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E-MAIL：
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聲明日期： 年 月 日
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