Hamilton All Star Jazz Band Inc.

Gift Donation Form

Silent Auction: Friday, January 29, 2010

Please Print Clearly:

Donor’s Name(s): (as you would like it to appear on the bidder form)

______________________________________________________

Donor’s Name and Address (for the thank you letter)

Name:_________________________________________________

Address: _______________________________________________

City: ________________________Postal Code:_________________

Telephone(H) _____________________ (W)___________________

Complete description of donation as you would like it to appear on the form

including restrictions and expiry dates (if any):

_______________________________________________________

_______________________________________________________

_______________________________________________________

Purchase Receipt Attached: Yes  No 

(If purchase receipt is not available, please attach any available Internet or other documentation.)

Internet Documentation Attached: Yes  No 

Tax Receipt Requested: Yes  No 

(Please contact the Advancement Office for more information regarding tax receipt eligibility.)

905 648-3566

Receipt for Business Records Requested: Yes  No 

Note: Fair market value may be reviewed by a third party. Fair market values exceeding

$1 000.00 require independent appraisals. Donation receipts cannot be issued for the

donation of services, or gifts of inventory or certificates from an individual’s personal business.

______________________________________________________________________________

Estimated Fair Market Value: $ ___________________________