Gift Planning Form
This form may help you identify and communicate your gift planning interests.
My Gift Objectives:
___Specific purpose
Purpose__________________________________________________________
___Support where needed most (unrestricted)
___Help the museum now
___Make a gift later from my estate

My Personal Objectives:
__Increase my income __Provide for my spouse or other loved one
__Supplement retirement income __Diversify my assets
__Rebalance my portfolio __Reduce estate taxes
__Retain security of my assets now __Include the museum in my legacy
__Other_________________________________________________________________

Possible Charitable Plans:
__Bequest from will or living trust
__Retirement Plan beneficiary designation
__Life Insurance designation
__Life Income Gift:
__Pooled Income Fund
__Gift Annuity
__Charitable Remainder Trust

Donor and Asset/Property Data
Donor Name(s)________________________ ________________________
Names: Income Recipient(s)____________________ ________________________
Recipient’s Date of Birth: __/__/__ __/__/__
Donor(s) Tax Bracket Federal____% State___%
Donor(s) Adjusted Gross Income $_____________
Type of Asset/Property: ___Cash ___Securities ___Real Estate ___Other
Value of Cash/Asset/Property $___________ Income Yield _____%
Adjusted Cost Basis $____________

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