In Kind Donation Receipt
Company (if applicable)
City, State, Zipcode
Date Qty Description (material and/or labor) Value ($)
Item needs pickup: Yes No
If this item is for a future event (raffle, silent auction), please provide we will by happy to
display information about your gift or company. Please include any information, menus, etc.
with this donor receipt.
In-Kind Donations may be tax-deductible. My Possibilities is a 501 (c ) (3) tax-exempt
charitable organization. Please FAX or mail this receipt to My Possibilities. It will be signed
by a representative of the organization (to be valid) and returned to you. Please retain the
signed receipt for tax purposes. Thank you for your support of this program.
My Possibilities Representative: ___________________________ Date: _________________
Phone Number: ________________________ Email Address:________________________