Donor Information
Company Name: ____________________________________________________________________________
Contact Person: ____________________________________________________________________________
Address: __________________________________________________________________________________
City, State, Zip: _____________________________________________________________________________
Phone: _______________________________ Email: _____________________________________________
Gift-in-Kind Information
Estimated fair market value (by donor): $ _______________________
Any gifts-in-kind valued at $5,000 or more require an independent written appraisal provided by the donor.
Item Description: ______________________________________________________________________
Delivery/Pickup Necessary: _____ Yes _____ No
Faculty/Staff Name: ______________________________________________ Date:_______________
Donor Signature: ________________________________________________ Date:_______________
Faculty and Staff coordinating gift-in-kind must have approval from the Vice President of Academic Affairs
prior to submitting form to the Chattahoochee Tech Foundation.
Approving VP: ___________________________________________________ Date:_______________
Please return this form to:
Amanda Henderson
Chattahoochee Tech Foundation
980 South Cobb Drive
Marietta, GA 30060
This form does not serve as a receipt for this contribution, but is intended for our internal record keeping purposes only. A receipt
describing the items or merchandise donated will be mailed to the address supplied above. Chattahoochee Tech Foundation is
unable to include the estimated value on the donor receipt. It is the responsibility of the donor to substantiate the fair market
value for his/her own tax purposes. The donation of services, although very valuable and much appreciated, is generally not
considered tax deductible by the IRS. Please consult with your tax advisor to determine the tax implications of your gift.
Foundation Use Only:
Form Received By: ___________________
Date: ______________________________
Donation Received Date: ______________
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