Form 511nr - State Of Oklahoma Income Tax Return - 2006 Page 5
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52006 Form 511NR • page 5
Name(s) shown on Form 511NR
Your Social
Security Number
Donations from Refund
Schedule 511NR-F
This schedule allows you to make a donation from your refund to a variety of Oklahoma organizations. Information regarding each
program, their mission, how funds are utilized, and their mailing address are shown below and on the back of this form (Schedule
511NR-F Information). If you are not receiving a refund, but would like to make a donation to one of these charities, Schedule 511NR-F
Information lists the mailing address to mail your donation to the organization. If you are not receiving a refund and are wishing to
donate to the Oklahoma Organ Donor Education Fund, please see line 54 of Form 511NR.
Please check the box associated with the dollar amount you are wishing to have deducted from your refund and donated to that
organization. Then carry that figure over into the column at the right. When you carry your figure back to line 50 of Form 511NR,
please list the line number of the charity to which you donated. If you donate to more than one charity, please write a “99” in the oval on
line 50 of Form 511NR.
•
Oklahoma Wildlife Diversity Program . . . . . . . . . . . .
$2
$5
$_____ . . .
00
1 1 1 1 1
1
•
00
Low Income Health Care Fund . . . . . . . . . . . . . . . . .
$2
$5
$_____ . . .
2 2 2 2 2
2
•
00
Veterans Affairs Capital Improvement Program. . . . .
$2
$5
$_____ . . .
3 3 3 3 3
3
00
Oklahoma Breast and Cervical Cancer Fund . . . . . . .
$2
$5
$_____ . . .
•
4 4 4 4 4
4
Oklahoma City Bombing Memorial Fund . . . . . . . . . .
$2
$5
$_____ . . .
•
00
5 5 5 5 5
5
Oklahoma Organ Donor Education Fund . . . . . . . . . .
$2
$5
$_____ . . .
00
•
6 6 6 6 6
6
Okla. School for the Blind/Okla. School for the Deaf
$2
$5
$_____ . . .
00
•
7 7 7 7 7
7
•
Tulsa Reconciliation Educ. & Scholarship Trust Fund
$2
$5
$_____ . . .
00
8 8 8 8 8
8
•
Oklahoma Silver Haired Legislature Program . . . . . .
$2
$5
$_____ . . .
00
9 9 9 9 9
9
•
Support of Oklahoma Common Schools . . . . . . . . . .
$2
$5
$_____ . . .
00
10
10
10
10
10
10
•
Support of Oklahoma Road & Highway Maintenance
$2
$5
$_____ . . .
00
11
11
11
11
11
11
•
00
Support of Oklahoma Medicaid Program . . . . . . . . . .
$2
$5
$_____ . . .
12
12
12
12
12
12
•
00
County Fair Enhancement Fund . . . . . . . . . . . . . . . . .
$2
$5
$_____ . . .
13
13
13
13
13
13
•
00
Junior Livestock Auction Scholarship Fund . . . . . . . .
$2
$5
$_____ . . .
14
14
14
14
14
14
Support of Programs for Volunteers to Act as Court Appointed Special Advocates
15
15
15
15
15
•
for Abused or Neglected Children . . . . . . . . . . . . . . . .
$2
$5
$_____ . . .
00
15
•
Oklahoma Pet Overpopulation Fund . . . . . . . . . . . . .
$2
$5
$_____ . . .
00
16
16
16
16
16
16
•
Support the Retirement of Capitol Dome Debt . . . . . .
$2
$5
$_____ . . .
00
17
17
17
17
17
17
•
00
Support of the Oklahoma National Guard . . . . . . . . . .
$2
$5
$_____ . . .
18
18
18
18
18
18
00
19
19
19
19
19
Total donations (add lines 1-18, enter total here and on line 50 of Form 511NR) . . . .
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Schedule 511NR-F: Information
1 - Oklahoma Wildlife Diversity Program
The Oklahoma Wildlife Diversity Program is funded primarily by concerned Oklahomans. All donations provide for a variety of projects,
including research on Texas horned lizards and other rare wildlife, wildlife observation activities, such as statewide educational work-
shops, informational brochures and posters, and management of a bat cave purchased with previous program donations. If you are not
receiving a refund, you may still donate. Mail your contribution to: Wildlife Diversity Program, 1801 North Lincoln, Oklahoma City, OK
73105.
2- Low Income Health Care Fund
Oklahomans helping each other is what the Indigent (Low Income) Health Care Fund is all about. Donations made to the fund are used
to help provide medical and dental care for needy children and families. Every dollar you donate goes directly for health care costs. If
you are not receiving a refund, you may still donate. Mail your contribution to: Oklahoma Department of Human Services, Revenue
Processing Unit, Re: Indigent Health Care Revolving Fund, P.O. Box 25352, Oklahoma City, OK 73125.
3- Veterans Affairs Capital Improvement Program
You may donate from your tax refund to help the Department of Veterans Affairs to purchase equipment and develop capital improve-
ment projects and to acquire properties for expanding or improving existing projects. If you are not receiving a refund, you may still donate.
Mail your contribution to: Department of Veterans Affairs, P.O. Box 53067, Oklahoma City, OK 73152.
Continued...
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