Form Attach to your tax return if you claimed a total deduction (Rev.

. December 2012) of over $500 for all contributed property. Department of the Treasury Information about Form 8283 and its separate instructions is at www.irs.gov/form8283. Internal Revenue Service Name(s) shown on your income tax return

8283

Noncash Charitable Contributions

OMB No. 1545-0908 Attachment Sequence No. 155 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 Certain Publicly Traded SecuritiesList in this section only items (or groups of similar items) for which you claimed a deduction of $5,000 or less. Also, list certain publicly traded securities even if the deduction is more than $5,000 (see instructions). Part I Information on Donated PropertyIf you need more space, attach a statement.
1 A B C D E Note. If the amount you claimed as a deduction for an item is $500 or less, you do not have to complete columns (e), (f), and (g).
(d) Date of the contribution (e) Date acquired by donor (mo., yr.) (f) How acquired by donor (g) Donors cost or adjusted basis (h) Fair market value (see instructions) (i) Method used to determine the fair market value (a) Name and address of the donee organization (b) If donated property is a vehicle (see instructions), check the box. Also enter the vehicle identification number (unless Form 1098-C is attached) (c) Description of donated property (For a donated vehicle, enter the year, make, model, condition, and mileage, unless Form 1098-C is attached.)

A B C D E

Part II
2a

Partial Interests and Restricted Use PropertyComplete lines 2a through 2e if you gave 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).

Enter the letter 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 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 e Name of any person, other than the donee organization, having actual possession of the property

3a

Is there a restriction, either temporary or permanent, on the donees right to use or dispose of the donated property? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes No

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.
Cat. No. 62299J Form 8283 (Rev. 12-2012)

Form 8283 (Rev. 12-2012) Name(s) shown on your income tax return Identifying number

Page 2

Section B. Donated Property Over $5,000 (Except Certain Publicly Traded Securities)List in this section only items (or groups of similar items) for which you claimed a deduction of more than $5,000 per item or group (except contributions of certain publicly traded securities reported in Section A). An appraisal is generally required for property listed in Section B (see instructions).

Part I
4 a d g j

Information on Donated PropertyTo be completed by the taxpayer and/or the appraiser.

Check the box that describes the type of property donated:

b e h

Qualified Conservation Contribution Other Real Estate Intellectual Property

c f i

Equipment Securities Vehicles

*Art includes paintings, sculptures, watercolors, prints, drawings, ceramics, antiques, 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.

5 A B C D

(a) Description of donated property (if you need more space, attach a separate statement)

(b) If tangible property was donated, give a brief summary of the overall physical condition of the property at the time of the gift

(c) Appraised fair market value

(d) Date acquired by donor (mo., yr.)

(e) How acquired by donor

(f) Donors cost or adjusted basis

(g) For bargain sales, enter amount received

See instructions
(h) Amount claimed as a deduction (i) Average trading price of securities

A B C D

Part II

Taxpayer (Donor) StatementList each item included in Part I above that the appraisal identifies as having 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. Signature of taxpayer (donor) Date

Part III

Declaration of Appraiser

I 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 qualified appraisal or this Form 8283 may subject me to the penalty under section 6701(a) (aiding and abetting the understatement of tax liability). In addition, I understand that I may be subject to a penalty under section 6695A if I know, or reasonably should know, that my appraisal is to be used in connection with a return or claim for refund and a substantial or gross valuation misstatement results from my appraisal. I affirm that I have not been barred from presenting evidence or testimony by the Office of Professional Responsibility.

Sign Here

Signature Business address (including room or suite no.) City or town, state, and ZIP code

Title

Date Identifying number

Part IV

Donee AcknowledgmentTo 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, Part 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 property for an unrelated use?
Name of charitable organization (donee) Address (number, street, and room or suite no.) Authorized signature

Yes

No

Employer identification number City or town, state, and ZIP code Title Date Form 8283 (Rev. 12-2012)