Finance and Administration • Office of Accounting Services • Sponsored Program Accounting
240 Thomas Boyd Hall • Baton Rouge, LA 70803 • P 225-578-5337 • F 225-578-7217
REV 7/12/16
NOTICE OF NON-CASH/IN-KIND GIFT TO LSU AS523
Instructions
This form should be completed by LSU personnel only and should be submitted for non-monetary gifts received from
outside the University. This includes equipment, tools, software, paintings, and furniture as well as any other item that
could be deemed to have a value to the recipient. Also, the Act of Donation (AOD) must be completed by the donor for all
non-cash/in-kind donations, unless the donor requires a donation agreement or submits IRS Form 8283.
Complete and sign this form and submit it to the address noted. Please forward this form promptly upon receipt of gift
along with supporting documentation. Completion of this form is required to document the gift for donor tax purposes and
to record the gift on University property records.
Donor/Department Information
Program (Unrestricted Fund)
Donation Details
I certify that nothing of value was provided to the Contributor in return for this contribution.
Something of value was provided to Contributor. The dollar value and a brief description must be denoted below.
*Attach evidence of value – invoice, appraisal, price list, etc. If valued above $5,000, an independent qualified appraisal is required.
Absence of appropriate documentation will result in delay of recording or acceptance. For additional guidance, contact
Sponsored Program Accounting (225) 578-5337.
Approvals
________________________________________ ____________________________________________ _______________________________________
Preparer/Receiver Print Name Date
________________________________________ ____________________________________________ _______________________________________
Department Head Print Name Date
Sponsored Program Accounting
Date approved by University
Date submitted to Property Management
Louisiana State University
Office of Accounting Services
Sponsored Program gam Accountin
240 Thomas Boyd Hall
