Gift In Kind Donation Form printable pdf download

Foster Care Counts is able to better the lives of foster children and families, as well as promote awareness

about the foster care system thanks to the support of donors. Foster Care Counts is a tax exempt charitable

organization qualified under Section 501(c)(3) of the Internal Revenue Code. Donations are tax-deductible

as allowed by law. Tax ID #45-4619493. No goods or services were received for this donation. Please

Gift In Kind Donation Form

Donor Information:

First and Last Name: ___________________________________________________________

Organization: ___________________________ Phone: _______________________________

E-mail: __________________________________ Fax: ________________________________

Address: ________________________________ City/State: ____________________________

ZIP Code: ___________________________Country: __________________________________

Please send me future updates from Foster Care Counts by e-mail

Gift Information:

___ Small Bags

___ Medium Bags

___ Large Bags

(less than 7 items)

(7-15 items)

(more than 15 items)

Description of donated items: ______________________________________________________

______________________________________________________________________________

Gift Certificate Attached

Expiration Date:

Instructions re: Delivery/Pickup of Donation (Indicate location/ date/ time): __________________

_______________________________________________________________________________

Estimated Value:

Value of Items in Dollars

Signature: ______________________________________ Date: _________________________

11111 S anta M onica B lvd., S uite 1 650, L os A ngeles, C alifornia 9 0025 T el. 3 10-‐575-‐9400 x 122 F ax 3 10-‐575-‐9401

Gift In Kind Donation Form