Information Request Form

Please send me information regarding:

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

Yes
No
Uncertain

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

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.