Alpha Sigma Tau Foundation Statement of Intent

Planned Giving Statement of Intent

When you are ready to document your planned gift commitment with the Alpha Sigma Tau Foundation, please submit this form. To request an alternative version via email or mail, please call 317-613-7573 or email foundation@alphasigmatau.org.
This statement is an expression of my intent to provide for the future of Alpha Sigma Tau Foundation (EIN 63-0862852) through a planned or estate gift. The provision(s) made include the following:

An outright bequest upon the passing of the donor, or the passing of the donor and spouse.A life insurance policy, in which the Alpha Sigma Tau Foundation is named as a full or partial beneficiary.Retirement assets, in which the Alpha Sigma Tau Foundation is named as a full or partial beneficiary.A trust agreement, with income reserved for the donor, spouse, or other income beneficiary.Other
The estimated value of the gift is $ and/or blank%.
Purpose
It is my wish that the gift be used:

At Alpha Sigma Tau Foundation’s discretion, to create the greatest impact in our Sisterhood by supporting its most compelling needs and opportunities at the time of receipt.For an existing fund(s) or purpose.To create a fund or purpose. Please note: the creation of a new fund or organizational priority is at the final discretion of the Alpha Sigma Tau Foundation's Board of Directors. Your intent will be honored to the best of the organization's ability to ensure sustainability.
List existing fund(s) or purpose
Special circumstances of my gift may include:
I would like to work with the Alpha Sigma Tau Foundation to create a memorandum of understanding that details the purpose of my gift.

YesNo
Advisor Point of Contact (if applicable)
Name of Financial Advisor or Legal Counsel

First NameLast Name
Company Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number

Area CodePhone Number
Email
example@example.com
Recognition
The Alpha Sigma Tau Foundation appreciates the opportunity to acknowledge your commitment to our Sisterhood by publicly recognizing your planned gift intent through the Legacy Society. If you prefer to remain anonymous, however, we will respect your wishes.

I (we) permit the Alpha Sigma Tau Foundation to use my/our name(s) in printed lists of Legacy Society members, which may appear in annual reports, newsletters, digital publications including social media and the website, and/or other.I (we) prefer to remain anonymous during my/our lifetime(s). You may recognize my/our gift after receipt.I (we) prefer to remain anonymous during and after my/our lifetime(s).
Note for couples: We are happy to list you either separately or as a couple, depending on your preference. If you would like to be recognized as a couple, please complete this form accordingly.
Donor Information
Primary Donor/Member of Alpha Sigma Tau*

First NameLast Name
Chapter of Initiation
Birthdate

MonthDayYear
Date
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number

Area CodePhone Number
Email
example@example.com
Donor Signature

Clear
Spouse of Donor (If Applicable)

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number

Area CodePhone Number
Email
example@example.com
Spouse of Donor Signature (if applicable)

Clear
Should be Empty:

Planned Giving Statement of Intent

Purpose

Advisor Point of Contact (if applicable)

Recognition

Donor Information