PAF - Legacy Circle Survey

PA Foundation Legacy Circle

Confidential Survey

Please indicate which of the following statements applies to you (and your spouse/partner if applicable). *

A) I/we have provided for the future well-being of the PA Foundation through a provision in my/our estate plans.

B) I/we are not able to consider this type of support at this time, but may in the future.

If you chose A above, please select the way(s) in which you are providing for the future well-being of the PA Foundation:

Provision for PA Foundation in will or living trust

Retirement plan beneficiary designation

Charitable gift annuity

Charitable remainder trust

Charitable lead trust

Gift of real estate or personal property

Life insurance beneficiary

Declaration of provision:

Recognition name(s) for Legacy Circle listing:

May we use your name and likeness in printed and electronic recognition of the PA Foundation Legacy Circle?

Yes

No, I would like my intention to remain anonymous.

Please upload a photo/headshot.

Please tell us why supporting the long-term success of the PA Foundation is important to you (may be used in promotion about the PA Foundation Legacy Circle):

I/we would appreciate more information about:

First Name *

Last Name *

Street Address *

Address Line 2

City *

State *

Zip Code *

Phone Number *

Email Address *

Electronic signature: *

clear

Date: * +

Thank you for taking the time to respond.