Foundation Gift-In-Kind Form

Foundation Gift-In-Kind Form

Person Submitting Form*

Submitter Email Address*

Donor Name*

Donor Street Address*

Donor City*

Donor State*

Donor Zip*

Donor Phone*

Donor Email*

Gift Date*

Estimated Fair Market Value of Gift*

How was value determined*

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Description and Intention of Gift*

Restrictions, if any, on the use of the gift, time*

Serial/ID/VIN Number (REQUIRED FOR ALL VEHICLES)

Make/Brand

Model Number

Odometer Mileage (REQUIRED FOR ALL VEHICLES)

Program or Department Receiving Gift*

Risk Management Notified

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Facilities Services Notified

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Environmental Health and Safety Notified

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Asset Steward Name*

Asset Steward Email*

Vice President Name*

Vice President Email*

Additional Approver Name

Additional Approver Email

Email/Letter from Donor regarding gift attached?*

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File Upload

Drag and drop files here or

Foundation Use Only

Foundation Approval

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Send me a copy of my responses