As we approach the end of the quarter, I need to collect in-kind donation forms from those of you who contributed anything of value (aside from money) to LTDO during the period from January 1 – March 31. Examples might be postage stamps or items for the office. Your time is NOT considered an in-kind for reporting purposes.

I have attached a sample of how to fill out the state-mandated form, as well as the blank for you to fill. My (semi-humorous) sample shows how to fill out each section.

Upper left: name and address of committee (see sample)

Upper right: your name and address

In-Kind Sample, 4 20

Lower left: fill this out if, for example, you went to a store and bought the item; do not use if you donate something that was already in your own possession

Lower right: date, $ value, and description of the contributed item(s)

Sign and date at the bottom.

This form is NOT actually turned into the state, and you are not identified in my filing unless your donations, both cash and in-kind, exceed $150 for the quarter.


  1. Download and print the form.
  2. Fill out the form.
  3. Scan and email your form to, OR
    mail it to, or drop off at, my home (641 Sunset Drive, Naperville 60540).

Some of you have already turned in forms for this quarter. If you are unsure, feel free to email me at, and I will check. And of course I am happy to answer any questions you may have.

Thanks for your help, and for your contributions to the growth and success of LTDO!

Best regards,

Robert Sacks, Treasurer, LTDO