A Gift to [CompanyName]

A practical way to make a planned gift to [CompanyName] is to include [CompanyNickname] in your will or revocable trust, or as a beneficiary of your retirement plan or life insurance. If you have already made a provision to include [CompanyNickname] in your financial planning, please notify us by completing and returning this document. By documenting your bequest intention, [CompanyNickname] will have an opportunity to recognize your generous support in your lifetime.

Information provided to signify your bequest intention to [CompanyNickname] will remain completely confidential unless you authorize [CompanyNickname] to publicize your gift. [CompanyNickname] understands that all bequest provisions are revocable, and any intentions stated here are not binding on you or your estate.

I have made revocable gift commitments for [CompanyName] as follows (check all that apply):

Bequest Approximate value: $_______________

Life Insurance Policy Approximate value: $_______________

IRA or other retirement plan Approximate value: $_______________

Other asset Approximate value: $_______________

Recognition (Select one.):

I/we accept membership into the [LegacySocietyName] (recognition society for donors who have included [CompanyName] in their estate plan). Please publish my/our name(s) among your lists of [LegacySocietyName] members.
Please clearly print the text as it should appear: _____________________________________________

Please do not list my/our name(s) publicly.

________________________________________________
Signature

________________________________________________
Date

________________________________________________
Name (please print)

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Signature

________________________________________________
Date

________________________________________________
Name (please print)

Contact information—representative of my estate:

________________________________________________
Name

________________________________________________
Telephone

________________________________________________
Role

________________________________________________
Email

I have attached documentation from my will, retirement plan, life insurance policy, or trust.

If your gift is for a percentage of your estate, rather than a fixed amount, [CompanyNickname] will be happy to use your good faith estimate of the current value based on this percentage. While not required, you may wish to include a copy of the relevant portion of related documents.