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In Kind Gift Receipt
In Kind refers to donations of goods or services instead of cash.
Please note that according to IRS regulations, establishing a dollar value on donated goods or
services is the exclusive responsibility of the donor. Donated services are not tax deductible.
Company/Individual
Company Contact
Address
City/State/Zip
Phone (Home) Phone (Business) Email Address
Describe the donation
List condition of the good.
Leave blank for contributed
services.
Donor’s
estimate of fair
market value
Please check event donation is for: The MKE Experience Inspiration Soiree
PLEASE NOTE: The American Cancer Society cannot attach a proper dollar value to your
gift. Federal tax laws impose certain reporting obligations for charitable contributions of property
other than cash. IRS Form 8283 and its instructions can assist you with your reporting obligations.
The American Cancer Society gratefully acknowledges the In Kind gift(s) described above. Please
keep this receipt. Your contribution is tax deductible to the extent allowed by law.
Please return form to:
Kelsey Chapman, N19 W24350 Riverwood Drive, Waukesha, WI 53188
Email: [email protected]g | Phone: 608.662.7553 | Fax: 262.523.9433
For Office Use Only: Please make a copy of this receipt, complete the following and
send to the SSBC GL Team at [email protected].
Division Receiving Credit: Midwest
Please complete the following only if the donor specified an event or program for their gift(s):
Event/Program: The MKE Experience
Fund: 1
Activity: MWWMWKGAL
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