Scott Community College
Foundation Gift-In-Kind Motor
Vehicle Donation Record Form
All motor vehicles are donated to Scott Community College through the Scott Community College
Foundation and must be accompanied by this form, completed and signed by the donor at the time of the
gift, regardless of whether the donor requires a receipt for tax purposes. Return the completed form to the
Foundation Office.
The Foundation is now required by the IRS to complete a 1098-C form for all vehicle donations valued at
more than $500. A copy of the 1098-C form will be sent to the IRS and to the donor.
Instructions: This form must be completed in its entirety with the donor’s signature as well as that of the
college agent receiving the donation. The form then must be immediately submitted with all certificates of
ownership, title or transfer to: Scott Community College Foundation, 500 Belmont Rd., Bettendorf IA
52722
DONOR NAME/COMPANY:
ADDRESS:
CITY, STATE, ZIP:
PHONE:
DONOR CONTACT:
(If different from above)
MAKE, MODEL ANE YEAR OF VEHICLE:
PHONE:
VEHICLE IDENTIFICATION #:
DONOR ASSIGNED VALUE: $ (dollar value MUST be stated by DONOR)
As the donor/representative of this gift, I certify that the above gift was made to the Scott Community College
Foundation as that the dollar value assigned has been set by the donor and is true and accurate to the best of my
knowledge.
(donor / representative signature) (phone) (date)
(please print name here) donor ss# or tax ID# (required by IRS)
RECEIVED BY SCC COLLEGE AGENT:
(please print) College Agent Receiving Donation Signature & Date
Intended use for vehicle:
Check to confirm that the title of the vehicle has been signed over to: Scott Community College Foundation
FOUNDATION OFFICE USE ONLY BELOW LINE
Accepted By:
(Foundation Director) Date Processed
Acknowledgement Letter Sent 1098-C form completed for IRS 1098-C form sent to donor
(if $500 or more) (if $500 or more)
