Cancer Support Community of Greater Ann Arbor
Glenn Davis Legacy Society Planned Gift Intention Form
If more than one person is designating this gift, please list all donors.
First Name
Last Name
and
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Please print your name(s) as you would want it/them to appear on the Cancer Support Community of Greater Ann Arbor's Glenn Davis Legacy Society membership listing: (if Anonymous, please note)
I/We have made provisions for a gift to Cancer Support Community of Greater Ann Arbor as a part of my estate plan. This gift has been made using the following instrument(s):
Bequest/Will
Life Insurance Policy
Retirement Plan
Charitable Remainder Trust
Other
The estimated value of my/our gift is (optional & confidential)
IRA Distribution Amount
Stock Amount
Unrestricted gifts are most valuable to CSC because they allow the organization to allocate funds to wherever the need is greatest; however, if there is a particular area that you would like your legacy gift to support, please indicate below:
Unrestricted
Programs
The Brides Project
Sprout Love Financial Assistance Fund
Long-Term Opportunity Fund
Other
CSC understands that this confirmation is not legally binding. A member of the CSC staff will be in touch shortly.
Signature
Date
-
Month
-
Day
Year
Date
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Should be Empty: