Indivisible LRCA In-Kind Donation Report
Use this form to report IN-KIND donations (non-cash donations, made with no expectation of reimbursement).
Please submit receipts or assign your estimated Fair Market Value if no receipt is available.
Report may be submitted any time but MUST BE SUBMITTED BY THE END OF THE MONTH in which donation was made.
Submit additional reports as needed. Thank you for supporting Indivisible Little Rock & Central Arkansas!
Email address *
Your First and Last Name *
Today's Date *
MM
/
DD
/
YYYY
Date of In-Kind Donation *
Date on receipt or best estimate date of donation
MM
/
DD
/
YYYY
Classification of Donation *
Select the category that best describes how the donation will be used. You may only select one classification per form. If you have multiple categories on one receipt, you may the combine the totals (with tax) of any in the same classification and submit together but you will need to submit another form for any other donation classifications.
Description of Item/s of Donation *
Enter a description of the item. Examples of material goods: ream of paper, printer ink, posterboard, stamps, markers, snacks, drinks, etc. Examples of services: USPS, ZOOM, Social Media Boosts, website, etc. Also describe here if you are submitting multiple items in the same classification listed above. Example: Admin- ream of paper & HP ink jet; Social- 3 pks of water & 2 trays of cookies, etc.
Place of Purchase or Personal Donation *
Enter the place of purchase (store name) or if it was a personal donation (from personal belongings)
Do you have a receipt? *
Would you like to upload the receipt now?
If you do not upload receipt here, please submit to Treasurer by the end of the month.
Purchase Price or Fair Market Value *
Enter the price of purchase (total out-of-pocket cost) OR your estimated Fair Market Value (FMV) if you do not have a receipt or if it was a personal donation.
Is this a Recurring In-kind Donation? *
You must report a recurring in-kind donation EACH month it occurs.
Other Information?
Provide any addition information regarding this donation, including if the receipt entered will be used again for other submissions. THANKS!!
A copy of your responses will be emailed to the address you provided.
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. - Terms of Service