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There is no obligation on your part in requesting information or a personal analysis of your financial circumstances. Any information provided by you will be maintained in the strictest of confidences and any response by us is for your informational purposes only. If you do not wish to answer everything, please feel free to provide what you are comfortable telling us.

If you would prefer to mail or fax this information to us, please print this page and mail it or fax it (408-734-8455) to us.

Your Name:

Your Title:

E-Mail Address:


     (We must have this to respond to you by e-mail)

Phone Number:

Work Phone:

Mailing Address:


Information Request

Please contact me regarding:

Cash Gift
Appreciated Securities
Bequests
Real Estate
Gifts of Life Insurance
Gifts of Retirement Assets
Charitable Remainder Trusts
Bargain Sales
Retained Life Estate (definition)
Charitable Lead Trusts
Tangible Assets

Would you like to inform us of a bequest or other gift?


Yes, I have made a bequest or other legacy gift and would be pleased to have my name included as a donor.
Yes, I have made a bequest or other legacy gift but right now I would prefer to remain anonymous.

Additional Comments or Requests

 

Calculation Request.

With the following information, we will provide you with a calculation of your benefits using a Charitable Remainder Trust. There are other gift options that might be better suited for your individual financial circumstances which we will be glad to discuss with you. This is entirely confidential and the information you provide will be held in the strictest confidence.

Age:

If this trust is to last for the lifetime of another person in addition to yourself, please enter that other person's age:

The dollar amount of the trust you wish to establish:

If you wish to fund the trust with appreciated assets, such as stocks, please indicate the original cost or basis of the assets (please disregard if the funding is to be with cash):

Our calculation will make assumptions as to the payout rate and the actual date of the gift. These assumptions are simply to give you a general idea of the income and tax benefits such a gift will provide you. There are other variables that may affect the actual benefits. This calculation is just a general idea of the benefits based on the current information and market conditions available at this time.

If you wish, you may set up the trust now but generally defer the income to a future date (usng a flip trust based on age). If so, please indicate the age (both ages if for two persons) at which you would like to start receiving trust payments.
Your age at payment start:
Second person's start age:

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Return to the Planned Giving home page or to the Quick Guide to Legacy Gifts.

For more information or to contact The Parkinson’s Institute with questions or to discuss planned giving, please contact Richard M. Lamport, our planned giving specialist, at  415-970-2380.

Please note, individual financial circumstances will vary. The information on this site does not constitute legal or tax advice, either in whole or in part. Donor stories and photographs are for purposes of illustration only. As with all tax and estate planning, please consult your attorney or estate specialist. All material is copyrighted and is for viewing purposes only. Use of this site signifies your agreement with the terms of use. The content in this Planned Giving section has been developed for the Parkinson's Institute and Clinical Center by Future Focus. Please report any problems to section webmaster.

675 Almanor Avenue | Sunnyvale, CA 94085
408.734.2800 main | 408.734.8455 fax (Main) | 408.734.9208 fax (Clinic Secure)