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NACC Donation And/Or 
CMTC Escrow Account Deposit Form

Name and Address:

Phone Number and E-mail Address:


For Donations
Yes! I want to help support NACC's organizing work as well as increase the
funds available for NACC's grants program.  I enclose (please make the check
payable to NACC):

Donation Amount: __$500  __$200   __$100  __$50  __$25  __$15  __$5 __Other:___




For Deposits

Yes! I enclose my first deposit into the CMTC Escrow Account.  (Please make
check payable to: CMTC Escrow Account.)

I understand and affirm the following conditions for my deposits into the CMTC
Escrow Account:

• I am a conscientious objector/resister to military taxation who wishes
to pay any federal taxes and/or use my personal savings only for humanitarian,
nonviolent, and life-affirming purposes.
• Deposits are FDIC insured, and withdrawals from the Escrow Account can
be made on request (in writing), usually within two weeks.
• Interest earned on my deposits will be used by NACC to promote War Tax
Resistance and support human needs and social justice.
• Deposits by individuals who die and leave no instructions shall belong
to NACC. Deposits by people who move and leave no forwarding address, from
whom we do not hear and are unable to contact in five years, shall also belong
to NACC.

Please check one of the following:

___ I wish to support the Conscience Penalty Fund. In the event of IRS seizures
of CMTC funds as a result of non-cooperation with levies on individuals' deposits,
I authorize CMTC to remove $15 or 3% (whichever is less) from my/our account as
needed, but no more than once in a year, and deposit this amount in the Conscience
Penalty Fund.

___ I do not wish to support the Conscience Penalty Fund.


Signature:

Date:

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Donations and/or deposits can be mailed to:
NACC
P.O. Box 85541
Seattle, WA 98145

Thank you!