Gift-In-Kind Transmittal

Purpose:Submit this form to report non-monetary gifts received from outside the university. This includes equipment, tools, software, paintings, and furniture as well as any other item that could be deemed to have a value to the recipient.
Directions:Complete and sign this form and submit it to the address noted. Please forward this form promptly upon receipt of gift. Completion of this form is required to document the gift for donor tax purposes and to record the gift on foundation or university property records.
Date Gift Received
Description of Gift
Intended Use
Length of Use
Manufacturer / Model
Serial No. / Building / Room
Fair Market Value at Date of Gift
(Attach evidence of value - invoice, appraisal, price list, etc. If valued above $5,000, an independent appraisal is required. Absence of appropriate documentation will result in delay of recording or acceptance. For additional guidance, contact Director of Gift Accounting (540) 231 – 2829.)
Designation or Recipient of Gift

Will the donor receive any goods or services as a result of this gift? Yes No

If so, indicate the value and describe what the donor will receive:
Donor Name
Donor Address

Does donor wish to remain anonymous? Yes No

IRS Form 8283: Attached? Yes No To follow? Yes No

Restrictions on Use and Disposition (check first box OR complete questions 1 – 3)

Gift-in-kinddoes not contain proprietary technology, have restrictions on use and disposition, and does not require export review (skip questions 1 – 3). Examples include animal donations, trailers, building materials, and other items that do not contain proprietary technology.

Questions 1 – 3 should be answered for any gift-in-kind incorporating proprietary technology or restrictions on use and disposition. Special attention should be paid to items with the following export control keywords: Military, Munitions, Unmanned, Autonomous, Aircraft, Naval Vessels, Infrared, Night Vision, Space, Satellites, Intelligence, Nuclear, Encryption, Source Code, and Proprietary. In addition, if the item needs to be used, displayed, or disposed of in a particular way.

1)Are there any proprietary, confidential, any restrictions on use or disposition?

Yes / No / If yes, explanation:

2)Software Source Code Provided?Yes No

3)Export Controlled?Yes No

If yes, provide ITAR Category or Export Control Classification Number (ECCN):

(Attach email of approval from Export and Secure Research Compliance)

4)Environmental Health and Safety review and approval: Yes, approval attached No, not required

I acknowledge the following: (i) I have reviewed and will comply with the provisions in the Donation Agreement to the extent legally permissible, (ii) all personnel who use this equipment will be properly trained and it will be used in accordance with manufacturer’s instructions.

The undersigned hereby certify to the best of their knowledge that the information provided is complete and accurate.

Individual Receiving Gift Signature / Printed Name / Date
Department Head Signature / Printed Name / Date

This gift will be entered on the books of the Virginia Tech Foundation, Inc., and in most cases title will immediately be transferred to VPI&SU. Refer to University Policy 3950 for additional guidance.

VTF Determination: / Accept / Reject
(based on documentation provided) / VTF Representative / Date
For Development, VTF Accounting and VTF Controller Use Only
VTF Controller/Assistant Controller
_____ Form 8283 signed
_____ Original 8283 to donor
_____ Copy of signed 8283
forwarded to Accounting / VTF Accounting
_____ Gift entry verified
_____ Recorded in system
_____ Property transferred to VT
_____ Form 8283 to Assistant Controller / Development Office
_____ Gift entered
_____ Copied as necessary
_____ Transmittal and
documentation to VTF

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