Fillable Gift-In-Kind Donation Form (Palm Beach State College)

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Gift-In-Kind Donation Form (Palm Beach State College)

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Gift-In-Kind Donation Form
INSTRUCTIONS:
All items presented for acceptance MUST be vetted by (1) the PBSC Foundation, Inc. (2) PBSC Safety and
Risk Management and (3) College Business Services PRIOR to taking receipt of the item(s).
Complete Donor information below and proceed to the following steps.
• STEP ONE: Contact PBSC Foundation Office for signature and approval on possible additional
form(s) needed – i.e. appraisal, IRS form 8283, car title, etc. All gifts received by the Foundation
are transferred to the College and become College property.
• STEP TWO: Forward Gift in Kind form to Safety and Risk Management Office for approval and
signature.
• STEP THREE: Forward Gift in Kind form to Vice President of Business Services for signature and
approval.
• Please read Gift-in-Kind Guidelines on page 2 before submission.
Individual Donor or Corporation Name: _____________________________________________________
Contact Person: ________________________________________________________________________
Mailing Address: _______________________________________________________________________
City, State, Zip: ________________________________________________________________________
Phone: _________________________________ Mobile Phone: ______________________________
Item(s) to be donated: (Please include a description or attach an inventory of all items, condition, year,
quantity and, when appropriate, serial number)
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Page Two
Gift-In-Kind Donation Form
Fair Market Value (As determined by the donor): $__________________________
Donor: ______________________________________________________________________________
Signature Date
PBSC Department Contact: ______________________________________________________________
Name (Please Print) Campus Phone Number
________________________________________________
PBSC Email
1. PBSC Foundation, Inc. Approval:
_____________________________________________________________________________
David A. Rutherford, Vice President, Institutional Advancement & Executive Director, Foundation Date
2. PBSC Risk Management Approval: _________________________________________________
John Garofalo, Manager, Safety & Risk Management Date
3. PBSC Approval: ________________________________________________________________
James E. Duffie, Vice President, Finance and Administration Date
Please expedite the approval of this form within 72 hours. Upon final approvals, the Foundation will
contact the PBSC Department Contact to notify them that the College can take possession of the Item(s)
being donated and a copy of the approved Gift-In-Kind Donation Form with the appropriate signatures.
Gift-in-Kind Guidelines:
• A gift-in-kind is a non-cash gift of physical property or service. Examples of gifts-in-kind include,
but are not limited to books, supplies, equipment, artwork, autos and collections.
• All gifts-in-kind must be accompanied by verification of the value of the gift as determined by the
donor (e.g. receipt, documentation, appraisals, etc.) In order to be tax deductible, the IRS
requires gifts of $5000 or more to be accompanied by formal third-party appraisal and the IRS
form 8283 completed by a registered appraiser and signed by the Executive Director. It is the
responsibility of the donor to obtain the appraisal and IRS form.
• Please note: Palm Beach State College and the PBSC Foundation, Inc. are prohibited by IRS
regulations from establishing monetary values for gifts of real or personal property. Donations
are tax deductible in keeping with IRS regulations.
• The Foundation reserves the right to legal review prior to accepting a non-cash gift.
Revised 6/11/20
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Gift-In-Kind Donation Form (Palm Beach State College)

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Completed 23 July 2020

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