EVENT NAME
DATE
Auction Purchase Form
We appreciate your support of UC San Diego’s (dept name). All proceeds from the
sale of items in our auction benefit (dept. or purpose).
It is important we follow IRS guidelines. Therefore we want to ensure you are aware
that the amount of your purchase price that exceeds the stated Fair Market Value of the item
(disclosed on the bid sheets) is a tax deductible gift. Any amount paid up to the FMV is
considered an equal exchange and therefore is not a tax-deductible gift. Your receipt will
indicate each of these amounts.
Auction Item Purchased:
Purchase Price:
Fair Market Value:
Purchased By:
Purchaser’s Address:
Purchaser’s Phone number:
□ Enclosed is my check for $
, made payable to the:
University of California, San Diego
□ Please charge $
□ Visa
to my credit card:
□ MasterCard □ AMEX □ Discover
Name exactly as it appears on card:
Card number:
Expiration date:
Signature:
Development
9500 Gilman Drive, #0937, La Jolla, CA 92093-0937
Office: PHONE
Fax:
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