Charitable Donations Worksheets (Non Cash Contributions) TAXPAYERS NAME(S):

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1 5111 US ROUTE 5 P.O. BOX 210 WESTMINSTER STATION, VT OFFICE: (802) FAX: (802) Charitable Donations Worksheets (Non Cash Contributions) TAXPAYERS NAME(S): ENTITY TO WHOM DONATED: Year ===> Date Given ===> Note: This worksheet is provided as a convenience and aide in calculating most common non cash charitable donations. The source information used is from a Salvation Army "Valuation Guide". Although the values are believed to be reasonable, there are no warranties as to their accuracy. The user assumes all consequences and responsibilities in the event the valuations used here are challenged by guarantees or the Internal Revenue Service. Retain this worksheet with your receipts in your tax file. Your receipts should include a reasonably accurate description of items donated. LADIES' CLOTHING blouse bathrobes boots bathing suits coats dresses evening dresses fur hats handbags hats jackets nightgowns pant suits socks / stockings suits shoes skirts sweaters slips slacks sweat shirts / pants $ 2.15 $ 3.70 $ 5.25 $ $ 4.25 $ 8.43 $ $ $ 1.55 $ $ $ $ 4.25 $ $ $ $ $ $ $ $ 7.35 $ $ $ $ 2.10 $ $ $ $ 1.05 $ 4.73 $ 8.40 $ $ 4.20 $ 8.40 $ $ $ 4.20 $ 8.40 $ $ $ 6.90 $ $ $ $ 0.45 $ 0.90 $ 1.35 $ $ 6.30 $ $ $ $ 2.10 $ $ $ $ 3.15 $ 5.78 $ 8.40 $ $ 3.15 $ 9.45 $ $ $ 1.05 $ 3.68 $ 6.30 $ $ 3.70 $ 8.15 $ $ $ 1.00 $ 5.50 $ $

2 MEN'S CLOTHING casual wear jackets: fabric casual wear jackets: leather over coats pajamas pants - shorts raincoats suits dress slacks shirts sweaters shoes swim trunks sport coats sweat shirts / pants $ 7.90 $ $ $ $ $ $ $ $ $ $ $ $ 3.70 $ 7.10 $ $ $ $ $ $ $ 5.25 $ 8.93 $ $ $ 3.70 $ $ $ $ 2.65 $ 5.53 $ 8.40 $ $ 8.40 $ $ $ $ 1.00 $ 5.50 $ $ belts $ 3.15 $ 5.78 $ 8.40 $ ties $ 3.15 $ 5.78 $ 8.40 $ CHILDREN'S CLOTHING shirts boots coats dresses jackets jeans pants snowsuits shoes skirts sweaters slacks shirts socks $ $ $ $ $ 3.15 $ $ $ $ 4.75 $ $ $ $ 3.70 $ 8.15 $ $ $ 3.15 $ $ $ $ 3.70 $ 8.15 $ $ $ 4.20 $ $ $ $ 2.65 $ 5.93 $ 9.20 $ $ 1.60 $ 3.95 $ 6.30 $ $ 2.65 $ 5.53 $ 8.40 $ $ 2.10 $ 4.20 $ 6.30 $ $ 0.55 $ 1.08 $ 1.60 $

3 DRY GOODS blankets bedspreads chair covers curtains drapes pillows sheets throw rugs towels HOUSEWARES & SMALL APPLIANCES broiler ovens mixer / blender toaster coffee maker microwave dinner plates - each saucers - each cups - each glasses - each flatware - place setting of 4 pieces soup bowls serving dishes misc. utensils $ 2.65 $ 5.53 $ 8.40 $ $ 3.15 $ $ $ $ $ $ $ $ 1.60 $ 7.10 $ $ $ 6.90 $ $ $ $ 1.60 $ 7.10 $ $ $ 0.55 $ 2.38 $ 4.20 $ $ $ $ $ $ 6.30 $ $ $ $ 7.90 $ $ $ $ $ $ $ $ 0.55 $ 0.80 $ 1.05 $ $ 0.35 $ 0.58 $ 0.80 $ $ 0.40 $ 0.63 $ 0.85 $ $ 0.20 $ 0.25 $ 0.30 $ $ 0.35 $ 0.58 $ 0.80 $ $ 1.05 $ 2.10 $ 3.15 $ $ 1.05 $ 2.10 $ 3.15 $

4 SPORTING GOODS bicycles fishing rods with reels ice / roller / inline skates skis ski boots/bindings sleds tennis/racquetball rackets toboggans MISCELLANEOUS adding machines Christmas trees copier home computer ink jet printer laser printer fax machine mower (riding) mower (auto) power edger rototiller sewing machine snow blower telephone answering machine vacuum cleaner (working) carpet cleaner (working) $ $ $ $ $ 5.25 $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ 5.25 $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ 5.25 $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $

5 FURNITURE air conditioner stools chest clothes closet china cabinet convertible sofa (w/ mattress) crib (w/ mattress) baby carriage / stroller chair (upholstered) coffee table dresser w/ mirror desk dryer kitchen stove / range (working) end table figurines (lg.) fireplace set floor lamps folding beds gas stoves heaters high chair hi riser kitchen table kitchen cabinets kitchen chair mattress (double) mattress (single) pictures and paintings play-pens CD / DVD / record player (stereo) record player (components) rugs refrigerator (working) radio / stereo / tuner sofa TV b/w (working) TV color (working) trunk / suitcase wardrobe washer (working) $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ 5.25 $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ 7.90 $ $ $ $ $ $ $ $ $ $ $ $ 7.90 $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ 2.65 $ 6.58 $ $ $ $ $ $ $ $ $ $ $ 5.25 $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ 7.90 $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ 5.25 $ $ $ $ $ $ $ $ $ $ $

6 ENTER ITEMS NOT PROVIDED FOR IN THE ABOVE CATEGORIES. SET YOUR OWN VALUE. $ Quantity MY / OUR TOTAL BEST GUESS OF > > > > > > > > For more information about non cash donations see:

7 MILEAGE FOR CHARITABLE PURPOSES Charity Miles Per Diem Total CHARITABLE CASH CONTRIBUTIONS $0.14 $0.14 Out-of-Pocket Expenses $ US ROUTE 5 P.O. BOX 210 WESTMINSTER STATION, VT OFFICE: (802) FAX: (802) Organization CASH CONTRIBUTIONS Date Receipt Yes or No Amount Grand Total Cash Contributions