In Kind Donation Form - Henderson Community Foundation
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1In-Kind Donation Form
To be used by HCF Partner Funds when an in-kind
donation has been made on behalf of a component fund at HCF
Date:
Name of Fund*:
______________
*This fund is a component fund of the
Donor Name:
Henderson Community Foundation,
a recognized 501(c)3 corporation in
Fill out Donor Address below:
the state of Nevada.
Donor Address:
Donor Phone #:
Donor Email:
Contact Person:
_______________
Phone#:
(if different from donor)
Description: (For items: a brief description that, if available, includes manufacturer, model, and
serial number. For services: a description of the service that was provided)
_______________
Internal Use Only
Were any goods or services provided to the donor
in exchange for the contribution? Yes No
Fund Name:
HCF Board Initials:
If Yes, what was the value $
and provide a description:
Prepared by:
Please submit completed, signed form(s) with any available documentation to:
Henderson Community Foundation
2756 N. Green Valley Pkwy, Suite 268
Henderson, NV 89014
(702) 952-2640
Adopted 07/22/15 HCF will provide a thank you letter to the donor consistent with IRS regulations using the item description above.
F101
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