Estates and Bequests, Planned Giving

Yes
No, please do not include me/us in listings
Please indicate how you would like your name(s) to appear in the John Adams Savage Legacy Society. (Please note the amount of your intended gift will not be published)

Name:
Date of Birth:
Spouse Name:
Spouse Date of Birth:
Phone Number:	( ) - Second three digits Last four digits
Email:
New Intention:	(I/We have not previously shared any information with Carroll University about this intention.)
Updated Intention:	( I/We have previously provided Carroll University with gift intention information. Using this form, I/We are providing updated information. This form replaces all previous shared documentation.)
I/We have established a gift to benefit Carroll University in the future by means of:	Will or Trust Beneficiary-Life Insurance Policy Beneficiary-Retirement Plan Bank, Investment, or other other Financial Account Other
The anticipated value of my/our Gift is/will be approximately:
I/We wish to designate our Gift to be used for the following purpose(s):	Unrestricted (Carroll Fund) Restricted (Please explain below) Please contact me/us to discuss designation for my/our intended gift.
If Restricted Please Explain:
Please provide a general description of the gift provision (Examples include: asset to be donated or description of intended use):
Recognition:	Yes No, please do not include me/us in listings Please indicate how you would like your name(s) to appear in the John Adams Savage Legacy Society. (Please note the amount of your intended gift will not be published)
Signature(s):
Date:	Today

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