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!
Your First and Last Name
Date of In-Kind Donation
Date on receipt or best estimate date of donation
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.
Admin (office supplies)
Activism (Rally, March, Postcard Parties, etc)
Elections / Scorecard
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.
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.
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