Gift In-Kind Form

Thank you for your in-kind donation to DePelchin! Please fill out the form below to receive a gift acknowledgement/receipt and so we can properly thank you for your generosity.

Donor Information

Name(Required)

Prefix First Name Middle Last Name Suffix

Address(Required)

Home Address City State / Province / Region ZIP / Postal Code

Email(Required)

Home Phone (Optional)

Mobile Phone (Optional)

Gift Information

Date your donation was delivered to DePelchin:(Required)

This donation from:(Required)

Please provide company or group name, if applicable

This donation is for:(Required)

Check below if this donation is an Amazon order delivered directly to DePelchin.

This donation is a delivery from Amazon

Please provide detailed description of the gift(s) donated*(Required)

What is the estimated fair market value of this gift(s)? If unknown, please enter "1.00". Please only include dollar amounts without the dollar sign ($)

DePelchin is grateful for your in-kind donation. Please note that this form does not serve as a tax receipt for this contribution. A gift acknowledgement/receipt describing the items donated will be mailed to the address supplied above. The value of any item, regardless of amount, is used for internal gift reporting only; DePelchin is unable to include the estimated value on a donor receipt or acknowledgement. It is the responsibility of the donor to substantiate the fair market value for his/her own tax purposes.

*DePelchin reserves the right to discard or donate to another charity any gift deemed inappropriate or unsuitable for our clients.