Form 150-101-240 - Donated Crops Tax Credit
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1O R E G O N
D E PA R T M E N T
DONATED CROPS TAX CREDIT
O F R E V E N U E
Name of Grower
Social Security No.
Employer ID No.
Address
City
State
ZIP Code
Telephone No.
(
)
I am an individual or corporation making a qualified donation to a gleaning cooperative, food bank, or other charitable organization of a
crop that I have grown. The organization receiving the donation is engaged in the distribution of food without charge and the crop is
usable as food for human consumption. The donation is available because (check one):
I have supplied my contract quota with the wholesale or retail buyer.
I was party to a contingent supply contract. The buyer reduced my crop quota below what I expected to supply.
I have determined that I am making a donation of apparently wholesome food intended for human consumption.
DONATION (to be completed by the grower)
Date
Quantity
Wholesale Market
Price*
Description of Donated Crop
Donated
of Donation
1.
2.
3.
CALCULATION OF CREDIT (to be completed by the grower)
Quantity
Wholesale Market
Wholesale Value
( Quantity x Price)
Price
Description of Donated Crop
of Donation
1.
2.
3.
Total
Multiply by 10 percent
10%
Credit limited to tax liability
*Determination of Wholesale Market Price
The wholesale market price for each crop being donated is determined by either:
• The amount paid to the grower by the last previous cash buyer, or
• If there is no previous cash buyer, the market price of the nearest wholesale buyer or the regional u-pick market price.
Signature of Grower
Date
VERIFICATION OF DONATION (to be competed by receiving organization)
Name of Organization Receiving Donation
Telephone No.
(
)
Address
City
State
ZIP Code
I verify that the crop was (or will be) distributed to children, homeless, unemployed, elderly, or low-income individuals.
Signature of Official from Organization Receiving Donation
Date
X
150-101-240 (Rev. 12-03) Web
KEEP A COPY OF THIS FORM WITH YOUR TAX RECORDS.
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