Food Donation Accounting Statement

This is an accounting of food collected to be used by the donor as a receipt for tax deduction purposes. The material listed and valued within is based on the fair market value of such items and is to be used for non-profit rescue and development purposes.

I hereby attest that the following Accounting Statement is complete and accurate to the best of my knowledge. As the donor or acting representative of the donor I acknowledge the receipt of this accounting statement and have agreed to the donation of the items listed. In a review of this Accounting Statement I understand that if there is any question or disagreement of any or all of the listed items that I have 72 hours to make request back of said items.

Donor/Supervisor Signature_____________________________________Date______________

I hereby attest that the following Accounting Statement is complete and accurate to the best of my knowledge. As representative of _______________________________rescue I understand this Donation Accounting Statement and the donors right to revision or rescission within the given 72 hour period.

Rescue Representative Signature____________________________________Date___________