I authorize the Epilepsy Awareness Tri-County to charge the credit card listed below for the amount set forth.

701 E Santa Clara St.#33, Ventura, Ca, 93001/310-713-9463/ [email protected]

Epilepsy Awareness Tri-County is in the process of applying for 501(c)(3) tax-exempt status. If the IRS and FTB approve Epilepsy Awareness Tri-County's application, then the organization's tax-exempt status will be in effect as of July 2, 2024 (its date of incorporation) and your donation will be tax deductible. However, Epilepsy Awareness Tri-County cannot guarantee that it will receive tax-exempt recognition from the IRS or FTB. Therefore, if you choose to donate to Epilepsy Awareness Tri-County while its tax-exempt application is pending, you expressly acknowledge that the organization is not currently tax-exempt and that your donation may not be tax-deductible.

See https://www.irs.gov/charities-non-profits/charitable-organizations/contributions-to-organization-with-irs-application-pending for more information.