CHARITABLE DONATION RECEIPT
[ORGANIZATION NAME]
SELECT RECEIPT TYPE
☐ Cash/Check Donation Receipt
☐ Non-Cash (In-Kind) Donation Receipt
☐ Quid Pro Quo Donation Receipt (donor received goods/services)
☐ Vehicle Donation Receipt
☐ Stock/Securities Donation Receipt
OPTION A: CASH/CHECK DONATION RECEIPT
DONATION ACKNOWLEDGMENT
Receipt Number: [NUMBER]
Date of Receipt: [DATE]
Organization Information
Organization Name: [ORGANIZATION NAME]
Address:
[STREET ADDRESS]
[CITY], [STATE] [ZIP CODE]
EIN (Tax ID): [XX-XXXXXXX]
501(c)(3) Status: This organization is a tax-exempt public charity under Section 501(c)(3) of the Internal Revenue Code.
Donor Information
Donor Name: [DONOR NAME]
Address:
[STREET ADDRESS]
[CITY], [STATE] [ZIP CODE]
Donation Details
Date of Donation: [DATE]
Amount Received: $[AMOUNT]
Payment Method:
☐ Cash
☐ Check #[NUMBER]
☐ Credit Card
☐ Electronic Transfer
☐ Other: ________________________
Purpose/Designation:
☐ Unrestricted/General Operating
☐ Restricted to: [PROGRAM/FUND NAME]
☐ In Honor of: [NAME]
☐ In Memory of: [NAME]
Tax Deductibility Statement
[// GUIDANCE: IRS requires specific language regarding goods/services received]
☐ No Goods or Services Provided:
No goods or services were provided in exchange for this contribution. The entire amount of your donation is tax-deductible to the extent allowed by law.
☐ Intangible Religious Benefits Only:
No goods or services were provided in exchange for this contribution other than intangible religious benefits. The entire amount of your donation is tax-deductible to the extent allowed by law.
IRS Substantiation Language
This receipt serves as written substantiation of your charitable contribution as required by Section 170(f)(8) of the Internal Revenue Code for contributions of $250 or more.
Please retain this receipt for your tax records. You must have this written acknowledgment in your possession on or before the earlier of (1) the date you file your tax return, or (2) the due date (including extensions) for filing your return.
Acknowledgment
Thank you for your generous support of [ORGANIZATION NAME]. Your contribution helps us [BRIEF MISSION STATEMENT].
Authorized Signature:
_________________________________________
[NAME], [TITLE]
Date: [DATE]
OPTION B: NON-CASH (IN-KIND) DONATION RECEIPT
IN-KIND DONATION ACKNOWLEDGMENT
Receipt Number: [NUMBER]
Date of Receipt: [DATE]
Organization Information
Organization Name: [ORGANIZATION NAME]
Address:
[STREET ADDRESS]
[CITY], [STATE] [ZIP CODE]
EIN (Tax ID): [XX-XXXXXXX]
501(c)(3) Status: This organization is a tax-exempt public charity under Section 501(c)(3) of the Internal Revenue Code.
Donor Information
Donor Name: [DONOR NAME]
Address:
[STREET ADDRESS]
[CITY], [STATE] [ZIP CODE]
Donated Property Details
Date of Donation: [DATE]
Description of Donated Property:
| Item | Quantity | Condition |
|---|---|---|
| [ITEM DESCRIPTION] | [QTY] | ☐ New ☐ Good ☐ Fair |
| [ITEM DESCRIPTION] | [QTY] | ☐ New ☐ Good ☐ Fair |
| [ITEM DESCRIPTION] | [QTY] | ☐ New ☐ Good ☐ Fair |
Additional Description:
[PROVIDE DETAILED DESCRIPTION OF ITEMS DONATED]
Valuation
[// GUIDANCE (CRITICAL): The IRS prohibits charities from valuing non-cash donations. The donor is responsible for determining fair market value.]
IMPORTANT: This organization is prohibited by IRS regulations from assigning a value to non-cash donations. The donor is solely responsible for determining and substantiating the fair market value of the donated property for tax purposes.
For donations valued at more than $5,000 (excluding publicly traded securities), the donor must obtain a qualified independent appraisal and complete IRS Form 8283.
Donor's Stated Value (for reference only): $[AMOUNT] (Organization makes no representation as to accuracy)
Statement Regarding Goods or Services
☐ No goods or services were provided in exchange for this contribution.
☐ The following goods or services were provided in exchange for this contribution:
[DESCRIPTION]
Fair Market Value: $[AMOUNT]
IRS Substantiation Language
This receipt serves as written acknowledgment of your non-cash charitable contribution as required by Section 170(f)(8) of the Internal Revenue Code.
For donations over $250: Please retain this receipt as your written acknowledgment.
For donations over $500: You must complete Section A of IRS Form 8283 and attach it to your tax return.
For donations over $5,000: You must obtain a qualified appraisal and complete Section B of IRS Form 8283.
Authorized Signature:
_________________________________________
[NAME], [TITLE]
Date: [DATE]
OPTION C: QUID PRO QUO DONATION RECEIPT
QUID PRO QUO CONTRIBUTION ACKNOWLEDGMENT
[// GUIDANCE: Use this receipt when the donor receives goods or services in exchange for a payment exceeding $75. Required disclosure under IRC Section 6115.]
Receipt Number: [NUMBER]
Date of Receipt: [DATE]
Organization Information
Organization Name: [ORGANIZATION NAME]
Address:
[STREET ADDRESS]
[CITY], [STATE] [ZIP CODE]
EIN (Tax ID): [XX-XXXXXXX]
501(c)(3) Status: This organization is a tax-exempt public charity under Section 501(c)(3) of the Internal Revenue Code.
Donor Information
Donor Name: [DONOR NAME]
Address:
[STREET ADDRESS]
[CITY], [STATE] [ZIP CODE]
Contribution and Goods/Services Details
Date of Contribution: [DATE]
Total Payment Amount: $[AMOUNT]
Description of Goods or Services Received:
[DESCRIBE EVENT TICKETS, MERCHANDISE, MEALS, ETC.]
| Item | Fair Market Value |
|---|---|
| [ITEM/EVENT] | $[AMOUNT] |
| [ITEM/EVENT] | $[AMOUNT] |
| Total Value of Goods/Services | $[AMOUNT] |
Tax-Deductible Amount
Total Payment: $[AMOUNT]
Less: Fair Market Value of Goods/Services: $[AMOUNT]
Tax-Deductible Portion: $[AMOUNT]
Required IRS Disclosure
In accordance with IRS regulations, we inform you that the estimated fair market value of the goods and/or services provided to you is $[AMOUNT]. Only the amount of your payment that exceeds the fair market value of the goods or services is deductible as a charitable contribution.
The tax-deductible portion of your contribution is $[AMOUNT].
Authorized Signature:
_________________________________________
[NAME], [TITLE]
Date: [DATE]
OPTION D: VEHICLE DONATION RECEIPT
VEHICLE DONATION ACKNOWLEDGMENT
Receipt Number: [NUMBER]
Date of Receipt: [DATE]
Organization Information
Organization Name: [ORGANIZATION NAME]
Address:
[STREET ADDRESS]
[CITY], [STATE] [ZIP CODE]
EIN (Tax ID): [XX-XXXXXXX]
501(c)(3) Status: This organization is a tax-exempt public charity under Section 501(c)(3) of the Internal Revenue Code.
Donor Information
Donor Name: [DONOR NAME]
Address:
[STREET ADDRESS]
[CITY], [STATE] [ZIP CODE]
Vehicle Information
Date of Donation: [DATE]
Vehicle Type: ☐ Car ☐ Truck ☐ Boat ☐ Aircraft ☐ Other: ____________
Year: [YEAR]
Make: [MAKE]
Model: [MODEL]
Vehicle Identification Number (VIN): [VIN]
Mileage/Hours (if applicable): [MILEAGE]
Condition: ☐ Excellent ☐ Good ☐ Fair ☐ Poor
Organization's Use or Disposition
[// GUIDANCE: IRS requires reporting how the organization used or disposed of the vehicle. Form 1098-C must be filed.]
☐ Vehicle Sold Without Material Improvement:
The vehicle was sold without any material improvements or significant intervening use.
Date of Sale: [DATE]
Gross Proceeds from Sale: $[AMOUNT]
The donor's deduction is limited to the gross proceeds from the sale: $[AMOUNT]
☐ Vehicle Used for Exempt Purpose:
The vehicle will be used by the organization in furtherance of its exempt purpose.
Intended Use: [DESCRIBE EXEMPT USE]
Duration of Use: [PERIOD]
☐ Material Improvement Made:
The organization made material improvements to the vehicle before sale or transfer.
Description of Improvements: [DESCRIBE]
☐ Given or Sold to Needy Individual:
The vehicle was given or sold at below fair market value to a needy individual in furtherance of the organization's exempt purpose.
IRS Form 1098-C
[// GUIDANCE: Organizations must provide donors with Copy B of Form 1098-C within 30 days of sale or within 30 days of donation if the organization intends to use the vehicle.]
☐ IRS Form 1098-C will be provided separately.
☐ IRS Form 1098-C is attached.
Authorized Signature:
_________________________________________
[NAME], [TITLE]
Date: [DATE]
OPTION E: STOCK/SECURITIES DONATION RECEIPT
SECURITIES DONATION ACKNOWLEDGMENT
Receipt Number: [NUMBER]
Date of Receipt: [DATE]
Organization Information
Organization Name: [ORGANIZATION NAME]
Address:
[STREET ADDRESS]
[CITY], [STATE] [ZIP CODE]
EIN (Tax ID): [XX-XXXXXXX]
501(c)(3) Status: This organization is a tax-exempt public charity under Section 501(c)(3) of the Internal Revenue Code.
Donor Information
Donor Name: [DONOR NAME]
Address:
[STREET ADDRESS]
[CITY], [STATE] [ZIP CODE]
Securities Donation Details
Date Securities Received: [DATE]
Security Name: [COMPANY/FUND NAME]
Ticker Symbol: [SYMBOL]
CUSIP Number: [CUSIP]
Number of Shares: [NUMBER]
Transfer Method:
☐ DTC Transfer to Organization's Brokerage Account
☐ Physical Certificate Delivery
☐ Other: ________________________
Valuation Information
[// GUIDANCE: For publicly traded securities, fair market value is the average of the high and low prices on the date of the gift.]
Date of Valuation: [DATE]
High Price: $[AMOUNT]
Low Price: $[AMOUNT]
Average (FMV per share): $[AMOUNT]
Total Fair Market Value: $[AMOUNT] ([NUMBER] shares x $[AMOUNT])
Statement Regarding Goods or Services
☐ No goods or services were provided in exchange for this contribution.
Additional Information for Donor
For securities held more than one year, the deduction is generally the fair market value on the date of the gift. For securities held one year or less, the deduction is limited to the donor's cost basis.
For donations of securities valued at more than $10,000, the donor may be required to complete IRS Form 8283.
Authorized Signature:
_________________________________________
[NAME], [TITLE]
Date: [DATE]
IRS REQUIREMENTS SUMMARY
| Donation Amount | Written Acknowledgment Required | Form 8283 Required | Appraisal Required |
|---|---|---|---|
| Under $250 | No (but recommended) | No | No |
| $250 - $500 | Yes | No | No |
| $501 - $5,000 | Yes | Section A | No |
| Over $5,000 (non-cash) | Yes | Section B | Yes |
| Over $500,000 (non-cash) | Yes | Section B (attach appraisal) | Yes |
[END OF DOCUMENT]
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