Recipient Information Submission Form
The information collected on this form will be used solely for the purpose of
verification of balances to be paid and payment submission on behalf of recipient.
As a recipient of financial assistance from Art of Life Foundation, Inc. I attest to the following:
I agree to provide the required information in order to receive financial assistance.
The information provided is said to be accurate to the best of my knowledge.
I understand that Art of Life Foundation, Inc. will issue payment directly to the companies for the verified balance due.