Donor Questionnaire - John M. Kelly Library

Name

This field is for validation purposes and should be left unchanged.

Name(Required)

First Last

Phone(Required)

Email(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Section 1: Details of the Gift

1.1 Nature of the Gift(Required)

Briefly describe the materials being offered (e.g., books, records, photographs, artworks, digital files, etc.) and explain why you think they may be relevant to Special Collections.

1.2 Extent of the Gift(Required)

Estimate the size of the gift, such as the number of items, boxes, volumes, or digital files. Note any special storage or handling needs.

Section 2: Ownership and Copyright

2.1 Is the Donor the creator of the Gift?(Required)

Select “Yes” if you created the materials yourself. Select “No” if they were created by someone else.

Yes

2.2 Is the Donor the sole owner of the Gift as property?(Required)

Select “Yes” if you are the only legal owner of the physical or digital materials being offered.

Yes

2.3 Does the Donor hold copyright over the contents of the Gift?(Required)

Select “Yes” if you own the copyright or other intellectual property rights in the materials.

Yes

Please describe

Please explain what copyright you own and whether anyone else may also hold rights in the materials.

Section 3: Copyright Transfer

3.1 Please select one of the following:(Required)

Choose the option that best reflects how you would like copyright to be handled.

I assign copyright to the University of St. Michael’s College upon execution of the Deed of Gift.

I retain copyright during my lifetime; copyright will transfer to the University of St. Michael’s College upon my death.

I retain copyright permanently; rights will pass to the estate representative named below. Provide the contact information for the person or office responsible for managing copyright after your death.

Name

First Last

Phone

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Section 4: Tax Receipt Information

4.1. Would you like to discuss the possibility of receiving an in-kind charitable tax receipt?(Required)

Select “Yes” if you would like the library to discuss whether your gift may be eligible for a charitable tax receipt. The monetary value of your gift will be determined based on the Canada Revenue Agency’s guidelines on valuation.

Yes

4.2. I have owned this property for three or more years.(Required)

This information helps determine how the gift may be valued for tax receipt purposes.

Yes

What was the cost to acquire the property?

Please provide the purchase price or acquisition cost, if known.

4.3. Did you receive the property as a gift or inheritance?(Required)

This information helps clarify how and when you acquired the property.

Yes

What was the fair market value of the property at the time of acquisition?

Provide the estimated value of the property when you received it, if known.

4.4. Did you acquire the property within the last ten years with intent to donate?(Required)

This information is required to help assess tax receipt eligibility and valuation.

Yes

What was the cost to acquire the property at the time of acquisition?

Please provide the purchase price or acquisition cost at the time you acquired the property.

Section 5: Access Restrictions

5.1. Are there restrictions on access to information within the Gift because of confidentiality or privacy?(Required)

Select “Yes” if the materials contain information that may need to be restricted, such as personal, confidential, sensitive, or private information.

Yes

Please outline the applicable restrictions. Be as detailed as possible.

Describe the information that should be restricted, the reason for the restriction, and how long the restriction should apply, if known.

5.2. May the Library release the Donor’s name and address so that researchers can request access and/or use of records directly from the Donor?

Select “Yes” if researchers may contact you directly about access to restricted materials.

Yes

5.3 Please specify who will be responsible for administering access requests.

Indicate whether access requests should be managed by the Library or by another person or organization.

The John M. Kelly Library, University of St. Michael’s College

Other (please specify name and address below)

Name

First Last

Phone

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Section 6: Donor Recognition

6.1. May the Donor’s name be published in the University’s annual donor report?(Required)

Select “Yes” if you consent to being publicly recognized in the University’s annual donor report.

Yes

Provide the Donor’s name as it should appear.

Enter the name exactly as you would like it to appear in Library catalogues, finding aids, or promotional materials.

Section 7: Financial Support

7.1. Would you like to be contacted about making a financial contribution to support the long-term preservation of your donation or to support the mandate of the John M. Kelly Libarry’s Special Collections: Archives and Rare Books division?(Required)

Select “Yes” if you would like someone from the University to contact you about ways to support the care and preservation of Special Collections materials.

Yes

Section 8: Transfer and Receipt

Date