Heifer International Foundation
Bequest Notification Form (NOTE: Please provide only the information you feel comfortable sharing.)
Donor(s) Title ________ Name ____________________________________________________________________ Address ________________________________________________________________________________ City ________________________________________ State ______________ Zip _________________ Date of Birth ________/________/________
Phone __________________________________________
Email Address __________________________________________________________________________ (Please notify us of changes in your address so we can stay in touch with you.) Executor Title ________ Name ___________________________________________________________________ Address _______________________________________________________________________________ City ________________________________________ State ______________ Zip _________________ Type of Bequest I (we) have made provision for (select one) □ Heifer Project International □ Heifer International Foundation in my (our) estate planning to support the mission of ending hunger and poverty and caring for the Earth as follows:
□
A stated gift in the amount of $ __________________
□
I (we) have included (select one) □ Heifer Project International □ Heifer International Foundation as a beneficiary of the asset indicated below: □ Retirement plan _______________________________________ □ Financial or investment account __________________________ □ Life insurance policy ___________________________________ □ Other asset(s) _________________________________________
□
A percentage of my (our) entire estate, for a percentage of ____________% Currently, this could result in a gift in the amount of $ ____________
□
A percentage of my (our) residual estate, for a percentage of ___________% Currently, this could result in a gift in the amount of $ ____________
□
I (we) have left my (our) entire estate for the benefit of the above named organization. Currently, this could result in a gift in the amount of $ ____________
I (we) request the funds be:
□
used where most needed by Heifer Project International
□
used for the programmatic work of Heifer Project International
□
added to the general endowment at Heifer International Foundation
□
added to the program endowment at Heifer International Foundation
Date ___________________ Signature _____________________________________________________ This form is non-binding and does not constitute a legal promise of any future donation to Heifer Project International or Heifer International Foundation. We understand that bequests are revocable and that your estate plans may change. If your estate plans should change, we would appreciate you letting us know.
Please return this form to: Heifer Foundation PO Box 727 Little Rock AR 72203
Questions? You may contact us at any time at: Phone: (888) 422-1161 Fax: (501) 907-4902 e-mail:
[email protected] Visit our website at www.heiferfoundation.org
