In-kind Donation Form

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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: [email protected]
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