Planned Gift Statement of Intent

As an indication of my/our desire to provide a legacy of support to PBS Wisconsin, I hereby inform the Friends of PBS Wisconsin that I/we have made a provision for a gift in my/our estate plan. I understand that this commitment is revocable and can be modified by me/us at any time.

Donor Information

Full Legal Name(s)*

Address*

Address Line 2 City State Zip

Phone*

Email*

Donor Recognition*

Yes, you may recognize me/us in donor lists and at events. Please list my/our name as follows:
I/We prefer to remain anonymous during our lifetimes, but you may recognize me/us after my/our gift matures.
I/We prefer to remain anonymous.

Recognition Name(s)

Description of Gift

Bequest through Will or Revocable Trust
Charitable Trust
Real Estate
IRA or Retirement Plan
Other
My/Our Provision Names Friends of PBS Wisconsin as the Beneficiary.
I/we understand that, by stating an amount, my/our Estate is not legally bound by this statement and I/we may choose to add, subtract or revoke this bequest at any time, at my/our sole discretion.

Bequest Type*

Percentage of Estate
Specific Amount

Percentage*

Amount*

Please describe IRA or retirement plan*

Please describe "other"*

I/we estimate the value of my/our gift to be approximately*

Purpose of Future Gift*

This gift is to be unrestricted and may be used where the need is greatest at PBS Wisconsin.
I/We wish to specify that this gift be used to support the following project(s) or purpose(s):

How gift is to be used*

Signature of Donor*

Date*

Friends of PBS Wisconsin Inc.
821 University Ave.
Madison, WI 53706

phone 855-343-2490
fax 608-263-0429

Friends of PBS Wisconsin, Inc. is a 501(c)3 organization. Federal Tax ID 23-7300462

Email

This field is for validation purposes and should be left unchanged.