In Kind Donation Form printable pdf download

In-Kind Donation Form

Thank you very much for making an in-kind donation to Four Mile Historic Park, Inc. enabling us

to fulfill our mission to educate, preserve, and interpret the western rural heritage of Colorado

to a diverse public. This form will help us to properly record and acknowledge your generous

gift. Please contact MacKenzie Pacifico, Director of Development & Marketing at 720-865-0813

if you have any questions, or would like us to take care of the

paperwork.

Donation and Donor Information (to be filled out by donor):

I/we wish to donate the following items to Four Mile Historic Park, Inc., as described below:

Donor Name(s):

Company/Organization:

Mailing Address:

City:

State:

Zip:

Phone:

Email Address(es):

Estimated Fair Market Value of the Donation: $

Date of Donation:___/___/____

Special Instructions, if any. Attach additional pages if necessary:

Please mark if you prefer to remain anonymous:  Yes  No

Signature of Donor(s):

>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>

Disbursement Information (to be filled out by Four Mile Historic Park, Inc.)

When the item(s) arrive contact MACKENZIE PACIFICO, DIRECTOR OF DEVELOPMENT & MARKETING.

Where are items stored? _________________________________________________ FMHP Initials: ____________

Intended use(s)for item(s): _______________________________________________________________________

AFTER GIFT IS RECEIVED, SEND THIS FORM TO Connie Wyatt, ACCOUNTING DEPARTMENT.

*The IRS requires, for our records and yours, that an estimation of the dollar amount of a non-cash contribution be

given. IRS publication 561, Determining the Value of Donated Property, is helpful for individuals, partnerships, and

corporations who make noncash contributions. If a non-cash contribution exceeds $500, the taxpayer must file IRS

Form 8283.

** No goods or services were provided in consideration for this gift. As a non-profit agency, Four Mile Historic Park, Inc. has been

granted tax-exempt status under Internal Revenue Service Code 501(c)(3). Copies of the IRS certification letter are available

upon request. Federal Tax ID: 84-0754945

Donor Privacy Policy: Four Mile Historic Park, Inc. does not sell or trade our donors’ personal or contact information.

Four Mile Historic Park, Inc.

715 S. Forest Street, Denver, Colorado 80246

| 720-865-0800 |

In Kind Donation Form