Art Donation Tax Deduction Statement

Date of Donation:

Donor Name:

Donor Address:

Recipient Organization:

Organization Address:

Tax ID (EIN):

Art Description

Title:

Artist:

Medium:

Dimensions:

Year Created:

Estimated Fair Market Value:

Donation Purpose/Use:

Received By (Name & Title):

Date Received:

Statement:
No goods or services were provided in exchange for this donation, other than those described above.

Donor Signature:

Date:

Recipient Signature:

Date: