Item #______
North Carolina Urban & Community Forestry Grant Program
Donated Goods and Services Documentation
This form is to be used for professional services, partially or fully donated, and for
donated materials. Partial value donations must be accompanied by an invoice for the
billed portion of the services or materials.
Donor’s name: _____
Description of Donation (e.g. plant materials, services, construction
drawings, installation, etc.):
Number of hours × hourly rate $ = $
Retail value of materials: $
Date of Donation:
Recipient Organization:
Donor: Agreed and Accepted By:
Signature Signature
Printed Name Printed Name
Date Date
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