Confidential Intention Form | Ascension Saint Thomas

Information submitted through this webform is not legally binding.

Personal Information

First Name:

Last Name:

Spouse First Name:

Spouse Last Name:

Address:

City/Town:

State/Province:

ZIP/Postal Code:

Phone:

Email:

Date of Birth:

Your Gift Intention

Please provide the following information and attach a copy of the documentation or appropriate language from your will or trust, if available. Please complete all that apply.

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I/We want to support the mission of Ascension Saint Thomas Foundation or Ascension Saint Thomas Rutherford Foundation through a planned gift as described below:

I/We have included a bequest for Ascension Saint Thomas Foundation or Ascension Saint Thomas Rutherford Foundation in my/our will or living trust.

I/We have named Ascension Saint Thomas Foundation or Ascension Saint Thomas Rutherford Foundation as a beneficiary of an asset:

Retirement Plan

Bank, Investment, or Other Financial Account

Life Insurance Policy

Other:

Approximate anticipated value of gift:

Please provide a general description of the gift provision (such as, asset to be donated if other than cash or securities, how gift is to be used, whether gift is to create an endowment, etc.):

Which organization did you put in your will?

Ascension Saint Thomas Foundation

Ascension Saint Thomas Rutherford Foundation

Signature:

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