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                                                                                 *61112221W*
         Illinois Department of Revenue 

         2022 Schedule G  Voluntary Charitable Donations
       Attach to your Form IL-1040                                                                                IL Attachment No. 24

                             Make a difference . . . Donate to a worthy cause. 
                             If you are receiving a tax refund, you can share it with the listed charities.  If you are not 
                             receiving a refund, you can still make a contribution. 

Step 1:  Provide the following information
                                                                                                   –               – 
Your name as shown on Form IL-1040                                                     Your Social Security number

Step 2:  Donations 

Note: Any donation will reduce your refund or increase the amount you owe. 

   1 Enter the amount you wish to donate to each of the following voluntary charitable donation funds. You may contribute any whole-dollar 
     amount of $1 or more.  See the instructions for a detailed description of each fund.  
                                                                                                     (Whole dollars only)

     a Wildlife Preservation Fund                                                                 a                      .00
         Donations support projects to protect and manage native plants and 
         animals in Illinois.

     b Alzheimer’s Disease Research, Care, and Support Fund                                       b                      .00
         Donations support research for the cure and treatment of Alzheimer’s Disease.

     c Assistance to the Homeless Fund                                                            c                      .00
         Donations support local not-for-profit agencies that provide shelter, meals, and 
         services needed by homeless families and individuals.

     d Diabetes Research Fund                                                                     d                      .00
         Donations support research on the detection, prevention, screening, management,
         and treatment of diabetes.

     e Hunger Relief Fund                                                                         e                      .00
         Donations support hunger relief programs including food banks, soup kitchens, 
         and other feeding programs for the needy. 

     f Ronald McDonald House Charities Fund                                                       f                      .00
         Donations support Ronald McDonald House charities. 

     g 100 Club of Illinois Fund                                                                  g                      .00
         Donations support the 100 Club of Illinois charity that provides resources to the 
         families of first responders killed in the line of duty and active duty first responders. 

 2   Add Lines  athrough   g.This is your total donation.  Enter this amount on Line 34 of  your 2022 Form IL-1040.       2                                                    .00

                                                                                 Reset Print
       IL-1040 Schedule G (R-12/22)                                                    This form is authorized as outlined under the Illinois Income Tax Act.  Disclosure of 
       Printed by authority of the state of Illinois. Electronic only, one copy.       this information is required.  Failure to provide information could result in a penalty.