Planned Giving Inquiry Form

Gift Annuity Inquiry Form The information you provide does not obligate you to establish a gift annuity. The illustration will show the amount of annuity payments you would receive and the tax benefit available to you.

1. I am interested in an illustration for: One life
Two lives

2. The illustration would be in the amount of:

Other Amount:

3. The property contributed would be:

Approximate cost basis for property other than cash: $

4. Names and dates of birth for annuitants (those who will receive annuity payments): First annuitant: Title
First Name *
Last Name *
E-mail Address *
Address *
City *
State *
Zip *
Daytime Phone
Evening Phone
Second annuitant (optional): Title
First Name
Last Name
E-mail Address
Address
City
State
Zip
Daytime Phone
Evening Phone
5. Names and address of donor: Donor: (optional) Title
First Name
Last Name
E-mail Address
Address
City
State
Zip
Daytime Phone
Evening Phone
* = required field

Thank you for requesting information on establishing a charitable gift annuity. We will contact you in a couple business days when the illustration is complete.

Submit

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