Form

Thank you very much for making a donation to the Junior League of Northern Virgina. This form will help us to properly record and acknowledge your generous gift. If you have any questions, please contact Donor Relations at contributions@jlnv.org.

The Junior League of Northern Virginia is a 501(c)(3) non-profit organization, Tax I.D. No. 54-0651635. Per IRS regulations, any item you value over $500 requires IRS Form 8283; any item you value over $5,000 requires Form 8283 and a written appraisal. Contributions of services and partial interest (e.g., use of beach condo) are not deductible as charitable contributions. Should you have any questions on the above, please refer to www.irs.gov publications 526 and 561, and consult your tax adviser.

1420 Spring Hill Road, Suite 600, McLean, VA 22102 Telephone: 703-442-4163 Fax: 703-761-4139 E-Mail: info@jlnv.org Web Site: www.jlnv.org

A member of The Association of Junior Leagues International, Inc.

Please use correct spelling and capitalization throughout this form so we can easily run acknowledgements.

Member Contact Information

Date donation was received:

First Name

Last Name

JLNV current standing:

Phone Number

Email Address

Did you solicit this donation as a member of a specific JLNV Committee?

If yes, on behalf of which committee did you solicit this donation?

Donor Information

Donor is Junior League of Northern Virginia member (same contact information as above)

Donor is an...

Donor Name (Organization/Company)

First Name

Last Name

Street Address

Address Line 2

City

State

Zip Code

Phone Number

Email Address

Donation Information

Donation Type

This donation is to be applied to (please select which campaign your donation will be applied to):

Description of In-Kind Donation (Please be sure to list all limitations, expirations, or conditions):

Value of donation (Enter fair market amount or value of donation as estimated by donor. All values should be in decimal format without the use of dollar signs or commas)

Obtaining the Donation

Donation has been received by a JLNV representative

If so, please specify:

If donation has yet to be delivered, please provide details as to when JLNV will receive the donation (include date and other specifics):

Other Information

If you have receipts, please submit via this field.

Is this donation a part of a larger donation (i.e., is this a part of a group tree for TEF)?

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In-Kind Contribution Form 2016 - 2017