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AttachmentDepartment of the Treasury Sequence No.Internal Revenue Service <br />If donated property is a vehicle, check <br />the box. Also enter the vehicle identification <br />number (unless Form 1098-C is attached) <br /> Date of the Date acquired How acquired Donor's cost or Fair market value Method used to determine the fairmarket valuecontributionby donor (mo., yr.)by donor adjusted basis (see instructions) <br />If any tangible personal property or real property was donated, give a briefsummary of the overall physical condition of the property at the time of the gift <br />419931 04-01-24 <br />OMB. No. 1545-0074 <br />(Rev. December 2023) <br />Form <br />Identifying number <br />Note: <br />Section A.Donated Property of $5,000 or Less and Publicly Traded Securities - only <br />(b)(c)(a)1 <br />A <br />B <br />C <br />D <br />Note: <br />(d)(e)(g)(i)(f)(h) <br />A <br />B <br />C <br />D <br />Section B.Donated Property Over $5,000 (Except Publicly Traded Securities, Vehicles, Intellectual Property or Inventory Reportable in Section A) - <br />Information on Donated Property <br />2 <br />a <br />b <br />c <br />d <br />e <br />f <br />g <br />h <br />i <br />j <br />k <br />l <br />b(1) <br />3 (b)(a)(c) <br />A <br />B <br />C <br />(d)(e)(f)(g)(h) (i) <br />A <br />B <br />C <br />For Paperwork Reduction Act Notice, see separate instructions.8283 <br /> Attach one or more Forms 8283 to your tax return if you claimed a total deduction <br />of over $500 for all contributed property. <br /> Go to www.irs.gov/Form8283 for instructions and the latest information. <br />Name(s) shown on your income tax return <br />Enter the entity name and identifying number from the tax return where the noncash charitable contribution was originally reported, if different from above. <br />Name:Identifying number: <br />Check this box if a family pass-through entity made the noncash charitable contribution. See instructions  <br />Figure the amount of your contribution deduction before completing this form. See your tax return instructions. <br />List in this section an item (or a group of similar items) for which you claimed <br />a deduction of $5,000 or less. Also list publicly traded securities and certain other property even if the deduction is more than $5,000. If you need more <br />space, attach a statement. See instructions. <br /> Description and condition of donated property(For a vehicle, enter the year, make, model, and mileage.For securities and other property, see instructions.) <br /> Name and address of the <br />donee organization <br />If the amount you claimed as a deduction for an item is $500 or less, you do not have to complete columns (e), (f), and (g). <br /> Complete <br />this section for one item (or a group of similar items) for which you claimed a deduction of more than $5,000 per item or group (except contributions <br />reportable in Section A). Provide a separate form for each item donated unless it is part of a group of similar items. A qualified appraisal is required for <br />items reportable in Section B and in certain cases must be attached. See instructions. <br />Check the box that describes the type of property donated. See instructions for definitions. <br />Art* (contribution of $20,000 or more)Other real estate Vehicles <br />Clothing and household items <br />Digital assets <br />Qualified conservation contribution Equipment <br />Certified historic structure Securities <br />NPS #Collectibles Other <br />Art* (contribution of less than $20,000)Intellectual property <br /> Description of donated property (if you needmore space, attach a separate statement)Appraised fair market value <br /> Dateacquired bydonor(mo., yr.) <br /> How acquiredby donor Donor's cost oradjusted basis For bargain sales,enter amountreceived <br />Qualifiedconservation contributionrelevant basis(see instructions) <br />Amount claimedas a deduction(see instructions) <br />Form (Rev. 12-2023) <br />LHA <br />155 <br />Part I <br />Noncash Charitable Contributions8283 <br />  <br />  <br />  <br />  <br />  <br />   <br />  <br />  <br />   <br />    <br />   <br />   <br />JODI S. BAKST & CORNELIS N. RADEMAKER 296-70-6222 <br />X <br />CONSERVATION EASEMENT AS AS DESCRIBED IN THE ATTACHED <br />DESCRIBED IN ATTACHED DEED DOCUMENTS 95,000. <br />08/21 PURCHASE 40,162.0.95,000.0. <br />CIRCULAR DESIGN CONSTRUCTION LLC (SMLLC)86-3083736 <br />Authentisign ID: 3806C182-C8A2-F011-8E61-002248330C80Docusign Envelope ID: 22497106-C86C-4810-AA3E-8EE2C4548575