Form 1098-C - Contributions Of Motor Vehicles, Boats, And Airplanes - 2017 Page 2

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VOID
CORRECTED
7878
1 Date of contribution
OMB No. 1545-1959
DONEE’S name, street address, city or town, state or province, country, ZIP
or foreign postal code, and telephone no.
Contributions of
2017
Motor Vehicles,
2a Odometer mileage
Boats, and
Airplanes
1098-C
Form
2b Year
2c Make
2d Model
DONEE’S federal identification
DONOR’S identification
3 Vehicle or other identification number
number
number
DONOR’S name
4a
Donee certifies that vehicle was sold in arm’s
length transaction to unrelated party
Street address (including apt. no.)
4b Date of sale
Copy A
4c Gross proceeds from sale (see instructions)
City or town, state or province, country, and ZIP or foreign postal code
$
For
5a
Donee certifies that vehicle will not be transferred for money, other property, or services before completion of material
Internal Revenue
improvements or significant intervening use
Service Center
File with Form 1096.
5b
Donee certifies that vehicle is to be transferred to a needy individual for significantly below fair market value in furtherance of
donee’s charitable purpose
For Privacy Act
and Paperwork
5c Donee certifies the following detailed description of material improvements or significant intervening use and duration of use
Reduction Act
Notice, see the
2017 General
Instructions for
Certain
Information
Yes
No
6a Did you provide goods or services in exchange for the vehicle? .
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Returns.
6b Value of goods and services provided in exchange for the vehicle
$
6c Describe the goods and services, if any, that were provided. If this box is checked, donee certifies that the goods and services
consisted solely of intangible religious benefits .
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7 Under the law, the donor may not claim a deduction of more than $500 for this vehicle if this box is checked .
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1098-C
Form
Cat. No. 39732R
Department of the Treasury - Internal Revenue Service

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