GF Policy Exhibit #1 – “Donation, Contribution, or Sponsorship Form”
| Policy Exhibit #1 | gF |
“Donation, Contribution, or Sponsorship Form”
Donation, Contribution, or Sponsorship Form
This form must be completed, signed, and turned in for all such occurrences greater than $250.
To be filled out by donor, contributor, or sponsor:
1. Date of donation: ___________________________________ (Must be prior to donation or initiation of construction.)
2. I am making this donation as (select one and fill in the legal name):
G An Individual ………………………………………………..Legal name: _________________________________________
- G An officer of a business ………………………………… Legal business name: __________________________________
- G An officer of a booster club with a tax id # ……… Legal club name: _____________________________________
For any of the above, if you wish this signed form to serve as a receipt from the authorized recipient for your own tax purposes, please provide the associated SSN, EIN, or TAX ID#: ____________________________________
- G A representative of an informal group (not eligible for tax receipt)…….. Name: ____________________________
- G Other (please describe) (not eligible for tax receipt)……___________________________________________
3. Type of donation:
- G Cash, coin, check …………………………… Dollar amount: _______________________________________________
- G Supplies, equipment, property, etc……. Estimated value: ______________________________________________
- G Volunteer time ………………………………. Estimated worth: _____________________________________________
4. Detailed description of what is being donated: _______________________________________________________________ ______________________________________________________________________________________________________
5. Program, school, department, class, or activity, if any, to which you restrict use of your donation. Restricted funds will be used only for the named restriction: (Donations may not be restricted to use for an individual employee.)
______________________________________________________________________________________________________
6. Representation: (Mark and sign appropriate one.)
- G Monetary or property donor:
I hereby certify that I hold legal title to the funds/property being donated, that I am authorized to make such donation, and hereby transfer full title of the funds/property being donated to the __________School District.
Signature: _______________________________________________________
- G Volunteer:
I hereby certify that I willingly donate my time and that I will not be compensated for my donated time by any source and that if I am given significant unsupervised access to a student in connection with my volunteer assignment, I must also obtain a volunteer form from the principal and complete it and submit it to Human Resources and be finger-printed.
Signature: _________________________________________
To be filled out by district/school recipient:
Authorizer per District’s donation policy: Received by District’s foundation/business administrator:
_____________________________________________ ________________________________________________
Name: Name:
_____________________________________________ ________________________________________________
Title: Title:
_____________________________________________ ________________________________________________
Signature: Date: Signature: Date:
_____________________________________________ ________________________________________________
Tax receipt number
________________________________________________
Distribution Original to Accounting Copy to Donor Copy for School/Department