Statement of Donor Intent The Legacy Society of the Eau Claire Community Foundation recognizes individuals and families who have made provision for a gift to the Foundation in their estate plan. Membership is by written confirmation of your deferred gift arrangements. Thank you for allowing the Eau Claire Community Foundation to assist you in carrying our your philanthropic goals. I have included the Eau Claire Community Foundation in my estate plan in this way: My will or revocable trust designates a portion of my estate to the Eau Claire Community Foundation. I/We have created a Charitable Trust with the Eau Claire Community Foundation as a beneficiary. I/We have designated the Eau Claire Community Foundation as a beneficiary of a Qualified Retirement Plan. I/We have established a Gift Annuity with the Eau Claire Community Foundation as the beneficiary. I/We have set up a life insurance policy with the Eau Claire Community Foundation as the beneficiary. I/We have set up a different plan. It is my/our intent that this gift be added to an existing fund at the Eau Claire Community Foundation and governed by all related agreements. It is my/our intent that this gift be allocated: It is my/our intent that this gift be used to create a new fund at the Eau Claire Community Foundation. I/We are interested in setting up a fund now at the Eau Claire Community Foundation. I have not made a decision yet, but I am interested. Call or email me regarding the Legacy Society. We have made other plans: It is my/our intent that this gift be added to an existing fund at the Eau Claire Community Foundation as governed by all related agreements (fund name): It is my/our intent that this gift be allocated: ($ or %) to the Community FundIt is my/our intent that this gift be allocated: ($ or %) to the Operations FundIt is my/our intent that this gift be used to create a new fund at the Eau Claire Community Foundation (fund name): The amount of my/our gift is estimated to be $ _________. (Optional) Name as it will appear in publications: First Last Address Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code PhoneEmail Agreement I/We accept your invitation to become a Legacy Society Member and give permission to use my/our name in Foundation publications. I/We wish the gift to remain anonymous until the Foundation receives my/our legacy bequest. I/We wish the gift to remain anonymous. Signature Date MM slash DD slash YYYY
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