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Kittitas County— Office of the Treasurer <br />205 W. 5th Ave., Suite 102, Ellensburg, WA 98926 <br />.,,,111.11kI,11 (509) 962-7535, tLaa3-L - co.l�iitita_ vv .us <br />Thank you for your generous contribution to Kittitas County Department. This <br />receipt is an attestation that we have gratefully received your donation. Keep this receipt for your <br />tax deduction purposes. <br />Date: <br />Name of the organization: <br />Amount of cash contribution: <br />Amount of non -monetary contributions: <br />Will there be ongoing costs related to non -monetary contributions: YES NO <br />i.e., maintenance, insurance, repairs, taxes, etc. <br />Description (but not value) contribution: <br />Tax deduction information: <br />If a donor wishes to claim a tax deduction for a donation that exceeds $250 (regardless of whether <br />the donation is monetary or non -monetary), the department/office must provide a written <br />acknowledgement to the donor, that contains the following: <br />A description and good faith estimate of the value of goods or services, if any, that the organization <br />provided in return for the contribution <br />and/or <br />A statement that no goods or services were provided by the organization in return for the <br />contribution (if that is accurate for the situation) <br />Approved: Not Approved: Signed: <br />Date: <br />Department head/Elected Official <br />