Confidential Intention Form

Information submitted through this webform is not legally binding.

Personal Information

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.

I/We want to support the mission of BSMH Foundation through a planned gift as described below:

I/We have included a bequest for BSMH Foundation in my/our will or living trust.

I/We have named BSMH Foundation as a revocable beneficiary of a charitable remainder trust.

I/We have named BSMH Foundation as an irrevocable beneficiary of a charitable remainder trust.

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.):

Yes, you may include me/us in listings of planned gift donors.

No, please do not include me/us in listings.

Signature:

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Confidential Intention Form

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Personal Information

Your Gift Intention

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