In-kind Donation

Date:

In-kind Donation Sports Club:

Donor Name: Donor Email Address: Donor Home Address:

Description of Item, Gift, or Service:

Fair Market Value: Check one of the following: Donor Signature Would like tax documentation to claim this donation Club Treasurer Signature (all requests): Date Received Form:

□ Donor Statement of Value □ Appraisal Attached □ Receipt Attached □ Yes □ No

Treasurer’s Use Only

Date Issued tax documentation:

NOTE: If any questions email or call Gwen Levit 770-490-7763 [email protected]

Gladiator’s Athletic Association, 5575 State Bridge Rd., Johns Creek, GA 30022

10/28/2015