Legacy Circle Confirmation Form

Legacy Circle Confirmation Form
I/We am/are pleased to advise the Walker Art Center of the following gift provision
in my/our estate plans:
Will or Revocable Trust

A bequest in a specific dollar amount.As applicable, my spouse’s or life partner’s will contains reciprocal gift languageA bequest of % of my/our estate
(the % of my/our estate bequeathed isEnter percentage here)
Retirement Plan Beneficiary Designation
Life Insurance Beneficiary
I/We estimate the current value of this gift to be: $Enter ammount here*
Name of Executor, Trustee, or Plan Administrator: First Name* Last Name*
For recognition purposes, please list me/us as:Enter info here
I/We wish to remain anonymous
I/We understand that this document does not represent a legal or binding commitment and that the amount listed above is an estimate. I/We will inform the Walker of any changes to my/our estate plan that impact the amount, type, or designation of my/our deferred gift
Name*

First NameLast Name
Signature*

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Date*

MonthDayYear
Date
Spouse/Partner Name

First NameLast Name
Spouse/Partner Signature

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Date of Spouse/Partner Signature

MonthDayYear
Date
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
If you have any questions, please contact Michelle Poss, Gift Officer at 612-375-5838
or michelle.poss@walkerart.org. Thank you!
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