Fillable Form 8283 (Rev. December 2013) - Noncash Charitable Contributions (Page 2 of 2) in pdf

Form 8283 (Rev. 12-2013)

Page

Name(s) shown on your income tax return

Identifying number

Section B. Donated Property Over $5,000 (Except Publicly Traded Securities)—List in this section only items (or groups of similar items)

for which you claimed a deduction of more than $5,000 per item or group (except contributions of publicly traded securities

reported in Section A). An appraisal is generally required for property listed in Section B (see instructions).

Part I

Information on Donated Property—To be completed by the taxpayer and/or the appraiser.

Check the box that describes the type of property donated:

Art* (contribution of $20,000 or more)

Qualified Conservation Contribution

Equipment

Art* (contribution of less than $20,000)

Other Real Estate

Securities

Collectibles**

Intellectual Property

Vehicles

Other

*Art includes paintings, sculptures, watercolors, prints, drawings, ceramics, antiques, decorative arts, textiles, carpets, silver, rare manuscripts, historical memorabilia, and

other similar objects.

**Collectibles include coins, stamps, books, gems, jewelry, sports memorabilia, dolls, etc., but not art as defined above.

Note. In certain cases, you must attach a qualified appraisal of the property. See instructions.

(a) Description of donated property (if you need

(b) If tangible property was donated, give a brief summary of the overall

more space, attach a separate statement)

physical condition of the property at the time of the gift

market value

(d) Date acquired

(f) Donor’s cost or

(g) For bargain sales, enter

See instructions

(e) How acquired by donor

by donor (mo., yr.)

adjusted basis

amount received

(h) Amount claimed as a

(i) Date of contribution

deduction

Part II

Taxpayer (Donor) Statement—List each item included in Part I above that the appraisal identifies as having

a value of $500 or less. See instructions.

I declare that the following item(s) included in Part I above has to the best of my knowledge and belief an appraised value of not more than $500

(per item). Enter identifying letter from Part I and describe the specific item. See instructions.

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Signature of taxpayer (donor)

Date

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Part III

Declaration of Appraiser

I declare that I am not the donor, the donee, a party to the transaction in which the donor acquired the property, employed by, or related to any of the foregoing persons, or

married to any person who is related to any of the foregoing persons. And, if regularly used by the donor, donee, or party to the transaction, I performed the majority of my

appraisals during my tax year for other persons.

Also, I declare that I perform appraisals on a regular basis; and that because of my qualifications as described in the appraisal, I am qualified to make appraisals of the type

of property being valued. I certify that the appraisal fees were not based on a percentage of the appraised property value. Furthermore, I understand that a false or

fraudulent overstatement of the property value as described in the qualified appraisal or this Form 8283 may subject me to the penalty under section 6701(a) (aiding and

abetting the understatement of tax liability). In addition, I understand that I may be subject to a penalty under section 6695A if I know, or reasonably should know, that my

appraisal is to be used in connection with a return or claim for refund and a substantial or gross valuation misstatement results from my appraisal. I affirm that I have not

been barred from presenting evidence or testimony by the Office of Professional Responsibility.

Sign

Here

Signature

Title

Date

▶

Identifying number

Business address (including room or suite no.)

City or town, state, and ZIP code

Part IV

Donee Acknowledgment—To be completed by the charitable organization.

This charitable organization acknowledges that it is a qualified organization under section 170(c) and that it received the donated property as described

in Section B, Part I, above on the following date

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Furthermore, this organization affirms that in the event it sells, exchanges, or otherwise disposes of the property described in Section B, Part I (or any

portion thereof) within 3 years after the date of receipt, it will file Form 8282, Donee Information Return, with the IRS and give the donor a copy of that

form. This acknowledgment does not represent agreement with the claimed fair market value.

Does the organization intend to use the property for an unrelated use?