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Product Donation Agreement Gifts In Kind International the world s

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Product Donation Agreement Gifts In Kind International, the world’s leading charity in product philanthropy, is the link between donor companies and recipient charities. Every year, Gifts In Kind International and its community partners distribute nearly $820 million in donated products to a global network of 200,000 charities. Although Gifts In Kind International’s donation management services are free, as a nonprofit, which operates very efficiently – at less than 1% of the value of products distributed annually, we appreciate and rely on financial assistance that companies can provide by making cash grants to help offset our costs associated with accepting and managing product donations. If your company is able to make a cash-deductible contribution to Gifts In Kind International, please submit your credit card number, attach a check or donate on line at https://www.giftsinkind.org/security/cash_donations.asp. Your support is appreciated! MasterCard Visa Am Ex Discover/Novus Charge Amount$_______ Card # __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ Expiration Date ____/____ Signature _____________________________________ Enclosed (Check) Check # ____________ Check Amount $_______ Just follow these steps to start the product donation process: 1. Complete this agreement. 2. Attach an inventory list. 3. Fax or email this agreement and your inventory list to Doyle Delph at Gifts In Kind International: 877-798-3192 or productdonations@giftsinkind.org. A member of the donation management team will contact you immediately to make arrangements to coordinate your donation. 4. If you have any questions or would like to discuss the development of an ongoing giving program, call Gifts In Kind International at (703) 836-2121. A. Donor Information and Agreement The company noted below promises to donate the inventory described in this agreement and on the attached inventory list to Gifts In Kind International. ___________________________________________ Company Name __________________________________________ Contact Person/Title __________________________________________________________________________________________ Street Address City ___________________________________________ State/Province, ZIP/Postal Code __________________________________________ Country _________________________ Telephone __________________________ Fax Title (print) ______________________________ E-mail ____________________________________________ Authorized company representative (print) __________________________________________ __________________________________________ Date ____________________________________________ Signature B. Donation Fair Market Value: $ _________________ USD or Canadian (What the recipient charity would pay for this product in the normal marketplace. This information is used to provide your company’s tax documentation.) C. Timeframe: When will your company be ready to make the donation? ________________________ D. Donated Transportation: Would your company be willing to donate shipping for this donation? Yes No E. Distribution: Where can this donation be distributed? restrictions) Specific countries (list) U.S. only Outside the U.S. only Globally (no F. Description: Provide a brief description of your donation and attach an inventory list and additional product information such as Web site descriptions, catalogs, etc. ________________________________________________________________________________ Important Notice: Gifts In Kind International encourages the donation of products classified for consumer use. If your donation does not fit this classification, please check here . If this box has been checked a representative from Gifts In Kind International’s donation development team will need to discuss and confirm our acceptance of the donation. Products that do not fit the consumer use classification which are shipped by the donor without prior approval by Gifts In Kind International will be returned to the donor and all charges incurred will be forwarded to the company for payment. G. Hazardous Material: Please check if classified as Hazardous Materials Form with the Product Donation Agreement. Please send MSDS Please Note: If products are found to be rated HAZMAT when they arrive at our facility and you have not provided advance information by noting the products status as HAZMAT, then the product will not be accepted from the carrier. H. Product Expiration Date (Time-Dating): Does the product you are donating have an expiration date or a time date? Yes No I. Quantity:_________ __________ __________ __________ __________ __________ Pieces/Eaches Pallets Cartons Weight Cubic feet Truckloads J. Type of Packaging: Shrinkwrap Mixed/Assorted Unit Packs Loose Other: Pallets Single Unit Packs K. Shipping Contact Information: If your donation’s point of origin is different than the address listed in Section A, complete this section. List a shipping contact, if different than the donor contact. ___________________________________________ Company Name Street Address State/Province, ZIP/Postal Code City __________________________________________ Contact Person/Title __________________________________________________________________________________________ ___________________________________________ ________________________ Telephone __________________________________________ Country ________________________ Fax ______________________________ E-mail L. If this is your first donation with Gifts In Kind International, please complete: How did you learn about Gifts In Kind International? Referred By Another Company (please list company name) Article in a publication (please list publication name) Web site (please list) Business Association (please list Association name) Received a Mailing From Gifts In Kind International Donated at a Tradeshow (please list Tradeshow) Other: Donated goods will be distributed by Gifts In Kind International to charities serving the ill, needy and youth; used strictly for their charitable purposes; and will never be sold, traded or bartered, or used for raffles or auctions. Any goods received from Gifts In Kind International will not be used with the intention or knowledge that the products will be used to commit a terrorist act. As soon as your donation is received Gifts In Kind International will send you the documentation required for the appropriate tax deduction. Gifts In Kind International Office Address – Do Not Ship To This Address, Call (703) 836-2121 for shipment instructions. 333 N. Fairfax St. Alexandria, VA 22314 U.S.A. +1 (703) 836-2121 +1 877-798-3192 (fax) www.giftsinkind.org

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