KC Shepherd's Center Elbert Cole Legacy Society - Legacy Gift Intention Form
Please count me (us) in! I am pleased to be a part of KC Shepherd's Center's Elbert Cole Legacy Society and make a difference in the ever growing number of older adults in KC.
Yes, count me in!
Enroll me/us in the Elbert Cole Legacy Society. As evidence of my/our desire to provide a legacy of support to KCSC with a future planned gift, I/we herby inform you that I/we have made a provision for a gift in my/our estate plans. It is my/our intent to leave a legacy gift to KCSC through a (please check all that apply):
Will
Living Trust
Life Insurance Policy
Retirement Plan Assets
Charitable Remainder Trust
Other (please specify below)
If you selected "Other" in the section above, please specify here:
I/We understand that my/our estate(s) are not legally bound by this statement and I/we may choose to add to, subtract from, or revoke this bequest at any time, at my/our sole discretion. *KCSC kindly requests notification any time you make changes or adjustments to your gift. Please use this space to share more details about this gift if you wish
I/We agree to have our names published on lists of legacy donors as inspiration for others to leave legacy gifts to benefit KC Shepherd's Center. *Note: The details of your gift will not be published and remains confidential.
Yes
No
Name(s) (please print)
Home Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Telephone number
Format: (000) 000-0000.
E mail address
example@example.com
Date(s) of birth
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Month
/
Day
Year
Date
Date(s) of birth
/
Month
/
Day
Year
Date
Donor(s) Signature(s)
Today's Date
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Month
/
Day
Year
Date
How Name(s) to Appear on Legacy Donor Listing: you have questions or would like more information, please contact Janet Baker, Executive Director at janet@kcshepherdscenter.org or at 816-293-9613
In case of emergency please contact
Phone number
Format: (000) 000-0000.
Email address
example@example.com
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