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2075 Occidental Road • Santa Rosa, California 95401 • 707-546-4543
Office Hours: Mon-Wed 10:00 am - 5:00 pm • Sat 10:00 am - 1:00 pm

Donate

Leaving A Legacy Statement of Commitment

 

Name______________________________________________________________Birthdate_____________________________________

 

Address_________________________________________________________________________________________________________

 

City, Sate, Zip____________________________________________________________________________________________________

 

Center for Spiritual Living Member             _____ Yes            ______  No

 

Email address  __________________________________________________________________________________________________

This Statement of Commitment notifies the Center for Spiritual Living, Santa Rosa Legacy Foundation that my estate plan contains the following provision to benefit Center for Spiritual Living, Santa Rosa, through a gift to the Legacy Foundation.  The nature of my gift is best described as:

[  ]A bequest to the Legacy Foundation in my will
[  ] A bequest to the Legacy Foundation in my trust
[  ]A present gift to the Legacy Foundation of cash______securities_______other, see below.
 

Designation of the Legacy Foundation as:

[  ]Primary beneficiary of my life insurance policy (all or a percentage)
[  ]Remainder beneficiary of my retirement plan (all or a percentage of my IRA, 401K, TSA, or deferred compensation plan.)
[  ]Remainder beneficiary of a Charitable Gift Annuity or Charitable Remainder Trust.
[  ]Successor beneficiary of a “payable on death” (POD) account.
[  ]Successor in title to a life estate in real estate, described below.
[  ]Other gift (description)__________________________________________________________________________________________

I hereby confirm that I have completed all legal documents necessary to ensure that my gift will be conveyed to the Center for Spiritual Living, Santa Rosa Legacy Foundation.

 

Signature__________________________________________________________________________________________Date___________

If the Legacy Foundation will receive your gift following another person’s use or interest, please provide the following information:

 

Name(s)________________________________________________

 If a financial institution will be involved in implementing your gift, please provide the following information:

Name____________________________________________________Capacity_______________________________________

 

Contact____________________________________________________Phone________________________________________

 

Personal Contact(s) below: [e.g. Attorney / Trustee / Personal Rep / Child / Sibling / Trusted Friend]

 

Name_____________________________________________________________________Relationship_____________________

 

Name_____________________________________________________________________Relationship_____________________

 

All the forgoing information is strictly confidential and will not be disclosed by the Legacy Foundation.

 

 

Commitment Delivery and Questions:

Please mail Commitment to:
Leaving A Legacy
Center for Spiritual Living, Santa Rosa,
2075 Occidental Road,
Santa Rosa, Ca 95401

If you have specific questions about the Legacy Foundation, please phone the Center for Spiritual Living, Santa Rosa,

 

Telephone:    
(707) 546-4543, ext. 302

 

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