Pre-Fill Your Receipt Info

Donation Receipt Request Form

Fill this out on screen and bring it on pickup day (or just print it for your records). Tracy uses the info below to source the donation receipt from a local Jacksonville 501(c)(3) — issued in your name.

Book Pickup Call (904) 988-2395

Your Receipt Info

All fields except notes are required for the IRS-compliant receipt.

1. Customer Information (Your Name on the Receipt)

Full Name *

Phone *

Mailing Address *

Email *

Pickup Date *

2. Items Being Donated (Approximate)

List of Items

Your Estimated Total Value *

Preferred Receipt Delivery

IRS guidance: For non-cash donations under $500, an estimate by the donor is generally sufficient. For items over $500, additional Form 8283 documentation may be required. Always consult your tax advisor.

3. Notes for Tracy (Optional)

4. Customer Acknowledgement

Customer Signature

Date

I certify that the items listed above are being donated voluntarily. I understand that Extra Mile Junk Removal acts as a transportation service and that the donation receipt is issued by the receiving 501(c)(3) charity, not by Extra Mile Junk Removal. I understand the receipt value is determined by IRS fair-market-value rules and the receiving charity's acceptance.

5. For Extra Mile Use (Completed at Drop-Off)

Charity Drop-Off Location

Drop-Off Date

Receipt # (from Charity)

Tracy's Signature

Photo Copy Sent (Y/N)

Ready to Book?

Print this and have it ready on pickup day — or just check the "Get my donation receipt" box in our online booking and Tracy will handle the rest.

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