This Bequest Intent Form is provided to donors who wish to inform Communities In Schools of Charlotte-Mecklenburg (CIS-Charlotte) of their desire to include CIS-Charlotte as a beneficiary in their estate plans. If you have any questions, please contact our Advancement Office at advancement@cischarlotte.org.

Bequest Intent Form

"*" indicates required fields

I/We wish to provide for the future well being of Communities In Schools of Charlotte-Mecklenburg through a provision in my/our estate plans. We are informing Communities In Schools of Charlotte-Mecklenburg of our plans with this completed Bequest Intent Form. I/We understand that this future commitment can be revoked or modified by me/us at any time.

Today's Date*

Name*

First Last

Address*

Street Address City State ZIP Code

Phone*

Email*

Type of Planned Gift*

I/We have made a provision to leave a legacy to Communities In Schools of Charlotte-Mecklenburg through my/our:

Will

Retirement Plan or IRA

Living Trust

Life Insurance Policy

Other Assets

I/We wish to inform Communities In Schools of Charlotte-Mecklenburg, for long-term planning purposes only, of the current value of my/our future gift, as stated below:

Current Value of Future Gift (approximate $ amount)

(This amount is kept confidential. If your gift is a percentage of your estate, please indicate the approximate value.) I/We understand that by stating an amount, I am/our estate is not legally bound by this statement and that I/we may choose to add, subtract, or revoke this bequest at any time, at my/our sole discretion.

Gift Recognition*

I give permission to publish my/our names when recognizing Communities In Schools Legacy Donors as a motivation for others to leave a legacy gift to Communities In Schools.

Yes

Bequest Intent Form

Bequest Intent Form

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