Planned Gift Notification Form

Confidential Planned Gift Notification Form

Name*
First Last
Date of Birth
Do you have a Spouse?*
Spouse's Name
First Last
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone*
Email*
MY/OUR WILL, AND/OR OTHER ESTATE PLANNING DOCUMENTS, WHICH INCLUDE A PROVISION FOR SATCHIDANANDA ASHRAM–YOGAVILLE, WERE EXECUTED ON:*
Type of Planned gift*
- BEQUEST UNDER WILL
- IRA
- LIFE INSURANCE
- CHARITABLE INTEREST IN TRUST
- CHARITABLE GIFT ANNUITY
- REAL ESTATE
MY PLANNED GIFT IS STATED AS:*
- A SPECIFIC AMOUNT
- A PERCENTAGE OF ESTATE (_____%)
- REMAINDER OF ESTATE
The Purpose/Designation of my gift*
Attorney Information
Attorney Name*
First Last
Attorney Phone*
Firm Name*
Firm Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Confirmation
Anonymous Gift?
I/WE PREFER THIS GIFT TO REMAIN ANONYMOUS.
Signature
Date
MM slash DD slash YYYY
Spouse's Signature
Date
MM slash DD slash YYYY