In-kind Donation Form To be filled out by the donor(s) at the time of donation. If donating more than one type of item, please use separate forms. Please Print Donor:______________________________________________________________________ Address:____________________________________________________________________ Phone: _____________________________________________________________________ Date of Gift:______________________________ Received by:_________________________________________________________________ Description of Gift: ___________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ Estimated Total Fair Market Value: $_________________ Gift intended for which College or Department:____________________________________ Signature of donor(s)__________________________________________________________ ____________________________________________________________________________ Based on the information on this form, a letter for tax purposes will be sent to the donor from the UW Oshkosh Foundation. The donor will be added to the Foundation mailing list and will be acknowledged in our printed materials. If you wish to remain anonymous, please indicate here:_________________________. Please note: The valuation of gifts and services is the responsibility of the donor. The IRS has substantiation requirements for contributions which total $250 and over. UW Oshkosh Foundation, 625 Pearl Ave., Oshkosh WI 54901-3556 Phone: (920) 424-2178 • Fax: (920) 424-7226 • Email: foundation@uwosh.edu