Humane Society InKind Donation Form

Thank you for your generous in-kind donation to the Appalachian Highlands Humane Society.

This form allows us to properly acknowledge your contribution for your records. In accordance with IRS guidelines, AHHS does not assign a dollar value to non-cash or service donations. Donors are responsible for determining fair market value, if applicable.

This form is provided after receipt of an in-kind donation by AHHS and is intended for acknowledgment purposes only.

Donation Information Person

Donor Information

Donor Type

Individual
Business

Name

First

Last

Address

Address Line 1

Address Line 2

City

State

Zip Code

Phone

Donation Details

Description of Item(s) or Service Donated

(Example: gift basket, veterinary supplies, photography services, office supplies, etc.)

Type of Donation

Date Donation Was Received by AHHS

Intended Use of Donation

Estimated Fair Market Value (Optional – for donor records only)

For donor records only. AHHS does not assign or confirm value.

Did you receive tickets or other benefits in exchange for this donation?

If yes, please describe

Required Confirmations

Donation Confirmation

I confirm that the donation described above has been delivered to and received by the Appalachian Highlands Humane Society.

IRS Acknowledgment

I understand that AHHS cannot assign a dollar value to in-kind donations and that I am responsible for determining fair market value for tax purposes, if applicable.

Signature

Donor Signature

Clear Signature

Date

Donor Information

Donation Details

Event Information

Required Confirmations

Signature