BIR Form No. 2322 December 2014 ‘Name of Instiuition/Organization ‘Address BIR Registiation No. Dated, CERTIFICATE OF DONATION (Tobe filled up by the Done) ‘TO ALL WHOM IT MAY CONCERN THIS IS TO CERTIFY that . "QName of Institution) — TIN, with address at _ =n oe (Cdaess of Institution) did, on donate ( ) Cash ( ) Personal Property(ies), ( ) Real Property(ies) deseribed as follows: 1.) Cash (©) Cheek Bank Name ____ Check No 2, Personal Property(ies) [___— Beseription | “Condition (ewe) — 3.Real Property(ies) 3.a Land Location Improvements _ Description Given this day of Signature Nae Posiion Title TIN: (Please sce the reverse side hereof)VALUATION OF DONATIO! FOR PURPOSES OF DEDUCTIBILITY FROM GROSS INCOME, (To be filled up by the Donor) L._Personal Property(ies) Description Condition (New/Used) | Acquisition Cost Nei Book Value ‘Total Value of Personal Property(ies) P 2. Real Property(les): 2a Land Location TCT No. “Requisition Cost 2.b Improvements Description Tocation | Acquistion | Depreciation | Net Book Value, Cost ‘Total Value oF Improvements P ‘TOTAL AGGREGATE VALUE OF DONATION Signature Name Position / Title TIN Taco "The fist page shal be led up bythe Donce andthe second page shal efile up by the Don, Dedetblity of Donation ‘The amount to be deducted fom the gross income shall be based onthe NetBook Value of the sid property a reflected in the financial statements ofthe donor. Please atch cevifed tue copy of Deed of Sale of Bil of Sal othe danor of ‘tification under ouh by the donor ofthe Net Book Value and acquiston cost The values declared by the donor shall sill be subject to further confmation bythe Bureau as tos corresiness and accuracy. 3. TheDonoe sal assume responsibility forthe consecutive numbering ofeach Cerificate of Donation, a fllows: For Regula Taxpayers Drocesooe-20ex Door RDO No.; xxx = number of Certfeate; 20x ~ year sued Example ‘DO48-001-2014 (Done belongs to RD No. 48, and Cerificate isthe fst sued for CY 2014) For Large Tuspayers: LTSanc-20q LTS Large Taxpayers Service, xxx numberof Cerafcate, 20x» ear sued Example [LTS-0122014 (Donge isa Large Taxpayer, and Certificate isthe twelth issued for CY 2014) 4. Consecutively numbered cxtification of donation should be distributed wishin thirty (30) days fom receipt of donation, as fallow: (Original Copy - Donor @) Duplicate Copy BIR @)—Tiplicate Copy = Donee