In-Kind Donation Form printable pdf download

In-Kind Donation Form

Donor Information

Name______________________________________________________________________

Company___________________________________________________________________

Address____________________________________________________________________

City_______________________________ State_________ Zip ______________________

Phone Number (_____)_____________ Email Address______________________________

Donation Information

Item(s)_____________________________________________________________________

___________________________________________________________________________

Total Fair Value $_____________

Description_________________________________________________________________

___________________________________________________________________________

Delivery/Pick-up Information (please check one option)

_____ I will arrange for the donation to be delivered to the Millionair Club Charity

(Monday-Friday 7:30 a.m.-2:00 p.m. through the back alley)

_____ I would like to have a Millionair Club Charity representative pick up the

donation

THANK YOU FOR YOUR GIFT! All donations are tax-deductible to the extent allowed

by law. An acknowledgement letter will be sent to you. In accordance to federal law, the

Millionair Club Charity does not place a valuation on your gift.

For more information, please contact:

Alexandra Comstock

office: 206.957.3843

Is this your first donation to the Millionair Club Charity?

Yes

How did you hear about the Millionair Club Charity? _______________________________

2515 Western Ave, Seattle WA 98121

Phone: 206.728.5627 • Fax: 206.957.3848

The Millionair Club Charity is a 501(c)3 nonprofit organization. Federal ID #91-0607513

In-Kind Donation Form