ADDITIONAL CHARITABLE CONTRIBUTION WORKSHEET
IRS Requirements for Cash Contributions: You cannot deduct a cash contribution, regardless of the amount, unless you keep as a record of the contribution a bank record (such as a
canceled check, a bank copy of a canceled check, or a bank statement containing the name of the charity, the date, and the amount) or a written communication from the charity.
The written communication must include the name of the charity, date of the contribution, and amount of the contribution.
Cash
Church
$
Official Charities
$
Airline Charity
$
School/Education Contributions
$
Charitable Miles Driven
mi.
IRS Requirements for Vehicle Contributions: The IRS requires written acknowledgment (1098-C) received from the charitable organization be attached to the return if you are
taking a deduction over $500. If your donation was valued at less than $500 please complete the following:
Vehicle
Name of Charitable Organization:
Date of Donation
Method to determine value:
Original Purchase Date & Price
$
Fair Market Value under $500
$
Make and Model of Vehicle: How acquired?
IRS Requirements for Non-Cash Contributions: The IRS requires an itemized list of all items donated and a receipt from the charitable organization.
Name and address are required for any donation over $500. Please make sure your receipt has a dollar value on it; if over $500, you must submit the receipts.
Non-Cash
Charitable Organization receiving donated goods:
Address of this organization:
Date of Donation
Resale Value of Furniture
$
Do you have an
itemized list and
the corresponding
receipt?
Yes No
Original Purchase Date: Resale Value of Clothing
$
How acquired? (purchase, inheritance, gift): Resale Value of Appliances
$
Original Purchase Price:
$
Resale Value of Household Items
$
Non-Cash
Charitable Organization receiving donated goods:
Address of this organization:
Date of Donation
Resale Value of Furniture
$
Do you have an
itemized list and
the corresponding
receipt?
Yes No
Original Purchase Date: Resale Value of Clothing
$
How acquired? (purchase, inheritance, gift): Resale Value of Appliances
$
Original Purchase Price:
$
Resale Value of Household Items
$
Non-Cash
Charitable Organization receiving donated goods:
Address of this organization:
Date of Donation
Resale Value of Furniture
$
Do you have an
itemized list and
the corresponding
receipt?
Yes No
Original Purchase Date: Resale Value of Clothing
$
How acquired? (purchase, inheritance, gift): Resale Value of Appliances
$
Original Purchase Price:
$
Resale Value of Household Items
$
Non-Cash
Charitable Organization receiving donated goods:
Address of this organization:
Date of Donation
Resale Value of Furniture
$
Do you have an
itemized list and
the corresponding
receipt?
Yes No
Original Purchase Date: Resale Value of Clothing
$
How acquired? (purchase, inheritance, gift): Resale Value of Appliances
$
Original Purchase Price:
$
Resale Value of Household Items
$
Non-Cash
Charitable Organization receiving donated goods:
Address of this organization:
Date of Donation
Resale Value of Furniture
$
Do you have an
itemized list and
the corresponding
receipt?
Yes No
Original Purchase Date: Resale Value of Clothing
$
How acquired? (purchase, inheritance, gift): Resale Value of Appliances
$
Original Purchase Price:
$
Resale Value of Household Items
$
Non-Cash
Charitable Organization receiving donated goods:
Address of this organization:
Date of Donation
Resale Value of Furniture
$
Do you have an
itemized list and
the corresponding
receipt?
Yes No
Original Purchase Date: Resale Value of Clothing
$
How acquired? (purchase, inheritance, gift): Resale Value of Appliances
$
Original Purchase Price:
$
Resale Value of Household Items
$
P.O. Box 139
|
Cicero, Indiana 46034
|
(317) 984-5812
|
317-984-5841 fax
|
flightax.com
Taxpayer Name: ____________________________________________________________________________ Phone Number:______________________
