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Illinois Department of Revenue
2012
Schedule G
Voluntary Charitable Donations
Attach to your Form IL-1040
IL Attachment No. 24
Make a difference . . . Donate to a worthy cause.
If you are getting a tax refund, you can share it with the listed charities. If you are not
getting a refund, you can still make a contribution.
Step 1: Provide the following information
–
–
Your name as shown on Form IL-1040
Your Social Security number
Step 2: Donations
Note: Any donation will reduce your refund or increase the amount you owe.
1
Write the amount you wish to donate to each of the following voluntary charitable donation funds. You may contribute any whole-dollar
amount of $1 or more. Note: A description of each fund is on the back of this schedule.
(Whole dollars only)
a
a
Wildlife Preservation Fund
.00
b
b
Child Abuse Prevention Fund
.00
c
c
Alzheimer’s Disease Research Fund
.00
d
d
Assistance to the Homeless Fund
.00
e
e
Penny Severns Breast, Cervical, and Ovarian Cancer Research Fund
.00
f
f
Military Family Relief Fund
.00
g
g
Diabetes Research Fund
.00
h
h
Hunger Relief Fund
.00
i
i
Childhood Cancer Research Fund
.00
j
j
Children’s Wellness Charities Fund
.00
k
k
Housing for Families Fund
.00
2
Add Lines a through k. This is your donations total. Write this amount on Line 33 of
2
your Form IL-1040.
.00
*261101110*
This form is authorized as outlined under the Illinois Income Tax Act. Disclosure of
this information is required. Failure to provide information could result in a penalty.
IL-1040 Schedule G front (R-12/12)