Thank you for your intention to make a bequest to the UUFSMA Endowment Fund. We appreciate your making UUFSMA and its community work part of your personal legacy of generosity.
We are requesting the information below for a couple of reasons. One is to help the Endowment Fund Committee with its work to administer the Fund. The more important reason is that when the time comes, far in the future we hope, that your Bequest is received, we want to be able to honor you and to communicate to the congregation something about you and your reasons for the Bequest.Thank you for taking the time to complete the form.
I/we are completing this form to demonstrate my/our commitment to support the continued mission of the UUFSMA in my/our estate plans via a bequest to the UUFSMA Endowment Fund. I/we understand that completion of this form is not intended to be legally binding. It is a notification of my/our intention at this time.
Name(s): ______________________________________________________________________
Postal address: ______________________________________________________________________
Home phone: _____________________ Mobile phone: ______________________
Email address(es): ______________________________________________________________________
Please indicate your type(s) of planned bequest below:
____ Bequest of cash or securities in my/our will
____ Life insurance policy
____ Beneficiary on an asset; for example:
____ Retirement account or IRA
____ Donor advised fund account
____ Trust of some kind
____ Other: ________________________________________________________
Real estate at (address): ________________________________________________
____ Other tangible property: ________________________________________________
____ Other: ______________________________________________________________
Country where the will containing the bequest will be probated:
____ USA
____ Mexico
____ Canada
____ Other: ______________________________________________________________
(Optional) Estimated value at this time of your planned bequest: _______________________________
(Optional) Name and contact information for the Executor of your will: ______________________________________________________________________
______________________________________________________________________
Have you placed any restrictions on the use of your bequest by UUFSMA? If so, please describe them here. If you need more space, please attach a separate page. Please also note the disclaimer below. ____________________________________________________________________________________________________________________________________________
I understand that if, in the judgment of the UUFSMA Board, changed circumstances should at some future time render the restricted use of this bequest no longer appropriate, then the Board shall use the bequest to further the objectives and purposes of UUFSMA, giving particular consideration to my special interest as described above.
The Endowment Committee would like to know a little about you, to help us honor and acknowledge you at some time in the future when your bequest is received. We encourage you to write a statement for us with some biographical information and also some information on why you are choosing to leave a Bequest to UUFSMA.Please send us this statement with your completed form.
Statement provided?: ___ Yes ___ No
Is there other information which you would like us to have? For example, are you making this bequest to honor someone’s memory?
______________________________________________________________________________________________________________________________
UUFSMA would like to thank and to recognize those who intend to leave a bequest to UUFSMA. We will occasionally publish in the UUFSMA newsletter or elsewhere the names of people who have notified us of their intended bequest. May we include your name on these lists, or do you prefer to remain anonymous?
____ Okay to include on lists.
Name(s) as we would like them to appear: ______________________________________________________________________
____ I/we prefer to be included on lists as “Anonymous”.
Recognition includes membership in our Legacy Circle of those who have made gifts or plan bequests to the Endowment Fund. Would you like to be included in events of the Legacy Circle?
____ Yes ____ No
Acknowledgements:
UUFSMA is a tax-exempt nonprofit organization recognized by Section 501(c)3 of the USA Internal Revenue Code. Bequests are deductible as allowed by law.
UUFSMA does not provide guidance on estate planning or taxation. Please discuss your planned bequest with your financial and legal advisors.
Bequests will be used at the discretion of UUFSMA as described in the UUFSMA Gift Acceptance Policy, a copy of which is available upon request.
Please return this completed form and address any questions to the Chairman of the Endowment Fund committee.
Signature ___________________________________ Date: _________________
Signature ____________________________________ Date: ________________
Endowment Fund committee use only:
Name of committee member who received this form: ________________________________________________________
Date: ______________
What if any approvals are required by the Gift Acceptance Policy for this intended bequest: ______________________________________________________________________
Have the required approvals been obtained? ____________________________________
______________________________________________________________________
Tracking identifier: ______________________________________________________________________
Any follow up required? _____________________________________________________
Has a short biography been prepared/provided? _________________________________
Has a statement of the reason for the Bequest been provided? ______________________
Has a photo been provided? __________________________________________________
Other notes: _______________________________________________________________
We are requesting the information below for a couple of reasons. One is to help the Endowment Fund Committee with its work to administer the Fund. The more important reason is that when the time comes, far in the future we hope, that your Bequest is received, we want to be able to honor you and to communicate to the congregation something about you and your reasons for the Bequest.Thank you for taking the time to complete the form.
I/we are completing this form to demonstrate my/our commitment to support the continued mission of the UUFSMA in my/our estate plans via a bequest to the UUFSMA Endowment Fund. I/we understand that completion of this form is not intended to be legally binding. It is a notification of my/our intention at this time.
Name(s): ______________________________________________________________________
Postal address: ______________________________________________________________________
Home phone: _____________________ Mobile phone: ______________________
Email address(es): ______________________________________________________________________
Please indicate your type(s) of planned bequest below:
____ Bequest of cash or securities in my/our will
____ Life insurance policy
____ Beneficiary on an asset; for example:
____ Retirement account or IRA
____ Donor advised fund account
____ Trust of some kind
____ Other: ________________________________________________________
Real estate at (address): ________________________________________________
____ Other tangible property: ________________________________________________
____ Other: ______________________________________________________________
Country where the will containing the bequest will be probated:
____ USA
____ Mexico
____ Canada
____ Other: ______________________________________________________________
(Optional) Estimated value at this time of your planned bequest: _______________________________
(Optional) Name and contact information for the Executor of your will: ______________________________________________________________________
______________________________________________________________________
Have you placed any restrictions on the use of your bequest by UUFSMA? If so, please describe them here. If you need more space, please attach a separate page. Please also note the disclaimer below. ____________________________________________________________________________________________________________________________________________
I understand that if, in the judgment of the UUFSMA Board, changed circumstances should at some future time render the restricted use of this bequest no longer appropriate, then the Board shall use the bequest to further the objectives and purposes of UUFSMA, giving particular consideration to my special interest as described above.
The Endowment Committee would like to know a little about you, to help us honor and acknowledge you at some time in the future when your bequest is received. We encourage you to write a statement for us with some biographical information and also some information on why you are choosing to leave a Bequest to UUFSMA.Please send us this statement with your completed form.
Statement provided?: ___ Yes ___ No
Is there other information which you would like us to have? For example, are you making this bequest to honor someone’s memory?
______________________________________________________________________________________________________________________________
UUFSMA would like to thank and to recognize those who intend to leave a bequest to UUFSMA. We will occasionally publish in the UUFSMA newsletter or elsewhere the names of people who have notified us of their intended bequest. May we include your name on these lists, or do you prefer to remain anonymous?
____ Okay to include on lists.
Name(s) as we would like them to appear: ______________________________________________________________________
____ I/we prefer to be included on lists as “Anonymous”.
Recognition includes membership in our Legacy Circle of those who have made gifts or plan bequests to the Endowment Fund. Would you like to be included in events of the Legacy Circle?
____ Yes ____ No
Acknowledgements:
UUFSMA is a tax-exempt nonprofit organization recognized by Section 501(c)3 of the USA Internal Revenue Code. Bequests are deductible as allowed by law.
UUFSMA does not provide guidance on estate planning or taxation. Please discuss your planned bequest with your financial and legal advisors.
Bequests will be used at the discretion of UUFSMA as described in the UUFSMA Gift Acceptance Policy, a copy of which is available upon request.
Please return this completed form and address any questions to the Chairman of the Endowment Fund committee.
Signature ___________________________________ Date: _________________
Signature ____________________________________ Date: ________________
Endowment Fund committee use only:
Name of committee member who received this form: ________________________________________________________
Date: ______________
What if any approvals are required by the Gift Acceptance Policy for this intended bequest: ______________________________________________________________________
Have the required approvals been obtained? ____________________________________
______________________________________________________________________
Tracking identifier: ______________________________________________________________________
Any follow up required? _____________________________________________________
Has a short biography been prepared/provided? _________________________________
Has a statement of the reason for the Bequest been provided? ______________________
Has a photo been provided? __________________________________________________
Other notes: _______________________________________________________________
