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HEF Form 5 IPC RETURN OF TAX-DEDUCTIBLE DONATIONS (For Calendar Year 20__) This Return is to be completed by IPCs. Name of IPC : (I) I IPC No.: Cash Donations (qualifying for double tax deduction - where donors have not received any benefit in return for the donation) Individuals ($) Corporations ($) Total ($) Cash Donations (including cheques) Deductions from Salaries GIRO Deductions, Credit Cards etc Total ($) II Donation of Shares or Unit Trusts under the Share Donation Scheme (qualifying for double tax deduction) Name of Recipient Organisation 1 2 Full Name of Donor ID of Donor (NRIC/FIN/RCB/ ROS No.) Name of Company No. of Shares/Units Trust Date of Donation1 Date of donation = Date when all legal procedures to effect the transfer of the shares / units to the recipient organisation are completed Value of donated shares or units in the units trusts = Market value as at the date of donation Value ($) 2 Name of Recipient Organisation Full Name of Donor ID of Donor (NRIC/FIN/RCB/ ROS No.) Name of Company No. of Shares/Units Trust Date of Donation1 Value ($) 2 Total ($) III Donation of Computers under the Computer Donation Scheme (qualifying for double tax deduction) Name of Recipient Organisation Full Name of Corporate Donor ID of Donor Date of Donation Value ($) (RCB No.) Total ($) IV Artefact Donation to Approved Museums (qualifying for double tax deduction) Name of Recipient Organisation Full Name of Donor ID of Donor (NRIC/FIN/RCB/ ROS No.) Date of Donation Value ($) Name of Recipient Organisation Full Name of Donor ID of Donor Date of Donation Value ($) (NRIC/FIN/RCB/ ROS No.) Total ($) Additional Information Non Tax-deductible donations ______________________ Name of Authorised Person $ _________________________________ Capacity in which the return is made Chairman/Treasurer/Secretary ________________________ Signature __________________ Date