Lake Worth Isd Donation Acknowledgement Form
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1Lake Worth ISD
DONATION ACKNOWLEDGEMENT FORM / TAX-EXEMPT STATUS
Lake Worth Independent School District is a public school district and is a political subdivision of the State of Texas. The
District is not a tax-exempt entity under the Internal Revenue Service (IRS) Code Section 501(c)(3). However, the district is
considered a tax-exempt organization that may receive charitable contributions according to the IRS Code Section 170(c)(1).
The district may receive charitable contributions if they are for public purposes, such as benefiting a group and not an
individual. These charitable contributions are deductible by the donor on their tax return. The federal identification number
of Lake Worth ISD is 1-75-6002344-6.
Contributions may be made to the district, district schools, or various district groups and clubs. However, the district's
tax-exempt status does not apply to various parent or community organizations, such as Booster Clubs and School Support
Organizations, who work with the district. These organizations are separate entities from the district and must apply for their
tax-exempt status under Code Section 501(c)(3). Evidence of their tax-exempt status would be a Letter of Determination
from the IRS.
Lake W orth I ndependent School District greatly appreciates the support of:
_________________________________________________________________________
Name of donor (Company or Person)
______________________________________________________________________________________________________________
Street address OR PO Box, City, State AN D Zip Code
__________________________________
_____________________________________
Printed Contact name/ Phone number
Signature of Donor and date
Type: (
) Cash/Check
(
) Gift Card
(
) Materials
(
) Equipment
Through the donation of (description of items(s) donated and/or monetary contribution received):
_________________________________________________________________________
_________________________________________________________________________
Donated to:
_________________________________ Received by:_________________________________
Purpose of Donation
: ______________________________________________________________________
Value of Donated Property
: $_____________________________________________________
Donor Imposed Restrictions, if any: ________________________________________________
This support will assist the district in continuing to improve the educational environment.
To Be Completed By District Official
Donation approved by: _________________________ Date: _______________________
(Superintendent, or Board of Trustees if value is equal to or over $5000)
---------------------------------------------------------------------------------------------------------------------
To Be Completed by Business Office
Date of Receipt: _________________ Amount Received (if cash): $__________________
[
] Cash
[
] Check #_________
Deposited to account #: ______________________
Fixed Asset Tag #: ________________ Location:_________________________________
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