Auction Donation Form

Auction Donation Form

*Submit donation items and completed form by April 1, 2022.
DONOR INFORMATION
Company (Official Company Name for recognition listing) Note: List N/A if not applicable. *
Donor Name (Official Individual Name for recognition listing) *

First Name Last Name
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Email *
Phone Number *
Number to call for redeeming donation.
Check if Contact Name is the same as Donor, If not complete below information. (Contact Name is person completing form and to contact regarding questions on item donation, ie. Certificates)

Yes
Contact Name (Assistant/Coordinator)

First Name Last Name
Contact Email Address
Notifications & a copy of this form will be sent to this email address.
Contact Phone Number
Please enter a valid phone number.
Which Hospitality Uncorked Committee Member referred you? *

DONATION DESCRIPTION

INCLUDE EXPIRATION DATES & RESTRICTIONS
Item Name: *
Full name of item as to be listed in online auction.
Item Description: *
Include detailed description and all restrictions.
Total Item "Fair Market Value" (REQUIRED) *
List as $xx.xx. For items valued at $5,000+, Appraisal and IRS Form 8283 is required.
If your donation consists of more then one item, please indicate the "Fair Market Value" amounts of each item.
(ie. Hotel Stay; Room, Tax, Resort Fee, Parking, Meals, Spa, Golf or other Activities.)
Individual Item & Individual FMV
Breakfast @ $40/day, Spa Service @ $150/each
Individual Item & Individual FMV
Breakfast @ $40/day, Spa Service @ $150/each
Individual Item & Individual FMV
Breakfast @ $40/day, Spa Service @ $150/each
Individual Item & Individual FMV
Breakfast @ $40/day, Spa Service @ $150/each
Individual Item & Individual FMV
Breakfast @ $40/day, Spa Service @ $150/each
Item Delivery *

Item to be E-Mailed *Preferred (event@hospitalityuncorked.com) Item to be Mailed (EM Hospitality, 28062 Tioga Court, Laguna Niguel CA. 92677) Other (Please Call for further review #909-632-7938)
Item Date Expiration: *

Month Day Year
Review of items, please provide one of the following:

If valued at $5,000+, provide IRS Form 8283 with Appraisal If purchased, provide Donor Statement of Value (ie Bill of Sale, Invoice with Proof of Payment, Item Print Out)
Signature

Clear
TAX ID #83-2300241

Cal Poly Pomona Foundation on behalf of Collins College of Hospitality Management
3801 W. Temple Avenue, Building 79B-2236, Pomona CA 91768

*Cal Poly Pomona does not set valuations on donations. It is a donor's responsibility to assign Fair Market Value, which is the price the buyer is willing to pay and a seller is willing to accept. Consult your tax advisor for professional assistance.
Hospitality Uncorked
event@hospitalityuncorked.com
#909-632-7938
Should be Empty:

Auction Donation Form

DONOR INFORMATION

DONATION DESCRIPTION

TAX ID #83-2300241