The written acknowledgment required to substantiate a charitable contribution of $250 or more must contain the following information:
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Name of the organization;
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Amount of cash contribution;
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Description (but not value) of non-cash contribution;
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Statement that no goods or services were provided by the organization, if that is the case;
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Description and good faith estimate of the value of goods or services, if any, that organization provided in return for the contribution; and
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Statement that goods or services, if any, that the organization provided in return for the contribution consisted entirely of intangible religious benefits, if that was the case.
In addition, a donor may claim a deduction for contributions of cash, check, or other monetary gifts only if the donor maintains certain written records.
Additional Information:
Publication 1771 PDF, Charitable Contributions - Substantiation and Disclosure Requirements