800 College Avenue, Weed, CA 96094 ~ 530.938.5373 ~ Fax 530.938.5570 ~ pio@siskiyous.edu
Gift‐in‐Kind Donation Form
Date
Please fill out this form completely and accurately with all available information and details. Please print carefully.
Legibility is essential for our records and for report accuracy. Donor’s name must be printed exactly as you would like it
to appear in publications.
Name of Donor:
Contact Person:
City:
Street Address:
Zip:
Day Phone: (
)
Evening Phone: (
)
Description of the Donation:
Estimated Retail Value: $
Restrictions, if any:
Pick Up instructions:
Important Information About Your Donation
You must file form 8283 if the amount of your deduction for all non‐cash gifts is more than $500. Please see the Foundation Office for non‐cash gifts valued over
$5,000.
If the value of any single non‐cash gift is over $5,000, you must also obtain a “qualified appraisal” in order to complete Form 8283.
If the College of the Siskiyous Foundation disposes of your non‐cash gifts over $5,000 within two years of receipt, the College of the Siskiyous Foundation must
complete IRS Form 8282 and send a copy to the IRS and you.
For COSF Office Use
COS Department to receive gift:
__
Cost of Accepting gift: $____________ Physical Location of Gift: _______________________________________________________
Accepted by:
__
( ) COS Department Chair
Date:
( ) COS Superintendent/President Date:
( ) COS Foundation Date:
__
Item received on:
Item received by:
Thank you from COS Foundation!
August 2012