EFTA01222778.pdf

Form 8283 (Rev. December 2014) Noncash Charitable Contributions ► Attach to your tax return If you claimed a total deduction OMB No. 1545-0908 of over $500 for all contributed property. Attachment Department of the Treasury Sequence No. 155 Interrul Revenue Service Ilk Information about Form 8283 and its separate Instructions is at www.lts.gov/form8283. Name(s) shown on your rilcome tax return Identifying number Note. Figure the amount of your contribution deduction before completing this form. See your tax return instructions. Section A. Donated Property of $5,000 or Less and Publicly Traded Securities—List in this section only items (or groups of similar items) for which you claimed a deduction of $5,000 or less. Also list publicly traded securities even if the deduction is more than $5,000 (see instructions). Information on Donated Property—If you need more space, attach a statement. (c) Description of donated properly (a) Name and address of the (b) If donated property is vehicle (see instructions). (For a vehicle. enter the year, make. model. and 1 check the box. Also enter the vehicle identification donee organization mileage. For securities. enter the company name and nattber (unless Form 1098-C is attached). the number of shares.) A 0 B 0 C 0 D 0 E 0 Note If the amount you claimed as a deduction for an item is 1500 or less. you do not have to complete columns tel ffl. and (al (d) Date of the (e) Date acquired 0) How acquired (9) Donor's cost (h) Fair market value (I) Method used to determine contribution by donor (mo.. yr.) by donor or adjusted basis See instructions) the fair market value A B C D E Lama Partial Interests and Restricted Use Property—Complete lines 2a throuah 2e if you nave less than an entire interest in a property listed in Part I. Complete lines 3a through 3c if conditions were placed on a contribution listed in Part I; also attach the required statement see instructions). 2a Enter the lette from Part I that identifies the property for which you gave less than an entire interest ► If Part II applies to more than one property, attach a separate statement. b Total amount claimed as a deduction for the property listed in Part I: (1) For this tax year ► (2) For any prior tax years P. c Name and address of each organization to which any such contribution was made in a prior year (complete only if different from the donee organization above): Name of charitable organization (donee) Address (number. street. and room or suite no.) City or town. state. and ZIP code d For tangible property, enter the place where the property is located or kept O. e Name of any person, other than the done organization, having actual possession of the property ► 3a Is there a restriction, either temporary or permanent, on the donee's right to use or dispose of the donated Yes No property? b Did you give to anyone (other than the donee organization or another organization participating with the donee organization in cooperative fundraising) the right to the income from the donated property or to the possession of the property, including the right to vote donated securities, to acquire the property by purchase or otherwise, or to designate the person having such income, possession, or right to acquire? c Is there a restriction limiting the donated property for a particular use? For Paperwork Reduction Act Notice, see separate Instructions. Form 8283 (Rev.12-2014 EFTA01222778 Form 8283 (Rev. 12-2014) Page 2 Name(s) sham, on your income tax return Identifying number Section B. Donated Property Over $5,000 (Except Publicly Traded Securities)—Complete this section for one item (or one group of similar items) for which you claimed a deduction of more than $5,000 per item or group (except contributions of publicly traded securities reported in Section A). Provide a separate tom for each property donated unless it is part of a group of similar items. An appraisal is generally required for property listed in Section B. See instructions. Part I Information on Donated Property—To be completed by the taxpayer and/or the appraiser. 4 Check the box that describes the type of property donated: a 0 Art* (contribution of $20,000 or more) d 0 Art (contribution of less than $20,000) g0 Collectibles— j 0 Other b 0 Qualified Conservation Contribution e 0 Other Real Estate h0 Intellectual Property c 0 Equipment f 0 Securities i 0 Vehicles 'Art includes paintings. sculptures. watercolors. prints. drawings, ceramics. anbques, decorative arts. textiles. carpets. silver. rare manuscripts. historical memorabilia. and other similar objects. "Collectibles include coins. stamps, books, gems, jewelry. sports memorabilia. dolls. etc.. but not art as defined above. Note. In certain cases, you must attach a qualified appraisal of the property. See instructions. (a) Description of donated property (dyou need (b) If tangible property was donated. give a brief summary of the overall (c) Appraised fair 5 more space. attach a separate statement) physical condthon of the property at the time of the gift market value A B r C D (d) Date acquired ft) Donor's cost or (g) For bargain sales. enter See Instructions (e) How acquired by donor by donor Ono.. yr.) adjusted basis amount received es Ameigucgird as a Di Date of conlribdico c A B C D inn Taxpayer Monad Statement—List each item included in Part I above that the appraisal identifies as havina a value of $500 or less. See instructions. I declare that the following item(s) Included In Part I above has to the best of my knowledge and belief an appraised value of not more than $500 (per item). Enter identifying letter from Part I and describe the specific item. See instructions. S. Signature of taxpayer (donor) ► Date ► 'Mal Declaration of Appraiser declare that I am not the donor. the donee. a party to the transaction in which the donor acquired the property. employed by. or related to any of the foregoing persons. or married to any person who is related to any of the foregoing persons. And, if regularly used by the donor. donee. or party to the transaction. I performed the majority of my appraisals during my tax year for other persons. Also. I declare that I perform appraisals on a regular basis: and that because of my qualifications as described in the appraisal. I am qualified to make appraisals of the type of property being valued. I certify that the appraisal fees were not based on a percentage of the appraised property value. Furthermore. I understand that a false or fraudulent overstatement of the property value as described in the quakfied appraisal of this Form 8283 may subject me to the penalty under section 6701(a) (aiding and abetting the understatement of tax lability). In addition. I understand that I may be subject to a penalty under section 6695A if l know. or reasonably should know. that my appraisal is to be used in connection with a retwn or clam for refund and a substannai or gross valuation misstatement results from my appraisal. !affirm that I have not been barred from presenting evidence or testimony by the Office of Professional Responsibility. Sign Here Signature► Title lo Date O. Business address (miming room or suite no.) Identifying number City or town, state, and ZIP code Part IV Donee Acknowledgment—To be completed by the charitable organization. This charitable organization acknowledges that it is a qualified organization under section 170(c) and that it received the donated property as described in Section B, Part I, above on the following date ► Furthermore, this organization affirms that in the event it sells, exchanges, or otherwise disposes of the property described in Section B. Pail I (or any portion thereof) within 3 years after the date of receipt. it will file Form 8282, Donee Information Return, With the IRS and give the donor a copy of that form. This acknowledgment does not represent agreement with the claimed fair market value Does the organization intend to use the properly for an unrelated use? Yes 0 No Name of charitable organization (donee) Employer Identification number Address (number. street. and room or suite no.) City a town. state, and ZIP code Authorized signature Tice Form 8283 (Rev 12-2014) EFTA01222779