Form 150-101-240 Draft - Crop Donation Tax Credit - 2015
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1
2Crop Donation Tax Credit
Tax year
ORS 315.154 and 315.156
/
/
This form is for tax years beginning
Fiscal year ending
January 1, 2015 and later only
Name of grower
Social Security no. or Federal ID no.
Phone
Address
City
State
ZIP code
I am an individual or corporation making a qualified donation to a gleaning cooperative, food bank, or other charitable organization of
a crop that I have grown. The organization receiving the donation is engaged in the distribution of food without charge and the crop
is usable as food for human consumption. The donation is available because (check one):
I have supplied my contract quota with the wholesale or retail buyer.
I was party to a contingent supply contract. The buyer reduced my crop quota below what I expected to supply.
I am making a donation of apparently wholesome food intended for human consumption, and I grow this food primarily for sale.
Determination of wholesale market price
The wholesale market price for each crop being donated is determined by either:
• The amount paid to the grower by the last previous cash buyer; or
• If there is no previous cash buyer, the market price of the nearest wholesale buyer or the regional u-pick market price.
Donation and calculation of credit. To be completed by the grower.
E.
A.
B.
C.
D.
Description of
Date
Quantity
Wholesale
Wholesale value
crops donated
donated
of donation
market price
(multiply column C x column D)
1.
2.
3.
4.
5.
6.
7. Total wholesale value (column E, lines 1–6) .......................................................................................7
× 0.15
8. Credit percentage ..............................................................................................................................8
9. Credit amount. Multiply line 7 by line 8. Enter result here and on Form 40, 40N, or 40P
using code 843, or code 820 on Form 20. 40N and 40P, multiply your credit by your Oregon
percentage. ........................................................................................................................................9
Signature of grower
Date
X
Verification of donation. To be completed by organization receiving the donation.
Name of organization receiving donation
Phone
Address
City
State
ZIP code
I verify the crop was, or will be, distributed in Oregon (a) without charge, and (b) to children or homeless, unemployed, elderly, or low-
income individuals, and (c) by a qualified charitable organization defined by Internal Revenue Code Section 501(c)(3).
Signature of official receiving donation
Name of official receiving donation
Date
X
Don’t attach this form to your Oregon return. Keep it with your tax records.
150-101-240 (Rev. 12-15) DRAFT 2, 09-14-15
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