Fillable GIFT IN-KIND DONOR FORM (Lewis-Clark State College)

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GIFT IN-KIND DONOR FORM (Lewis-Clark State College)

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Rev. 5/8/18
GIFT IN-KIND DONOR FORM
Name of Business or Individual: _______________________________________________________
Business Contact: _________________________________________________________________
Address: ______________________________________________________________________
______________________________________________________________________
Phone: __________________________E-Mail_______________________________________
Please list or attach a complete description of item(s) and serial number(s):
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
Purpose of donation (How will it be used by LCSC?): ______________________________________
________________________________________________________________________________
Donor’s Estimated value: $ _____________ as quoted by __________________________________
Donor Signature
(Note to donor: According to federal law, the donor must determine the value of the gift-in-kind for tax purposes. LCSC
employees are not authorized to place a value on gifts-in-kind. Your gift may require IRS Form 8283 be completed by you
with an appraisal of the donated property. Please consult your tax advisor.)
Date of receipt of donation: _____________ Received by___________________________________
LCSC Representative
Did this donor receive any good or services in return for this donation?
YES
NO
If yes, what is the value of stipend of goods received? _____________________________________
LCSC Representative Phone Number ______________E-Mail_______________________________
Please submit this form along with appropriate documentation (letters, MOUs etc. from or created with the donor
concerning the donation and/or its use/terms of agreement) to the College Advancement Office. Questions? Contact
208.792.2458 - awgill@lcsc.edu.
LCSC REP TO COMPLETE
DONOR TO COMPLETE
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GIFT IN-KIND DONOR FORM (Lewis-Clark State College)

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Completed 22 August 2020

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