Ellis C. Maxcy Legacy Society Commitment Form

Ellis C. Maxcy Legacy Society Commitment Form

The Ellis C. Maxcy Legacy Society honors individuals who value higher education and make sustaining the University of New Haven part of their legacy.
I/we have made provisions for the University of New Haven as follows:

I/we have made provisions for the University of New Haven as follows: Bequest in a will for a specified amount Bequest in a will for a specified percentage Trust (revocable) Trust (irrevocable) Life Insurance Retirement plan assets Other Other
Amount specified in bequest $ Dollars . Cents
Percentage specified in bequest
The estimated value of my gift is: $ Dollars . Cents
Estimate only, not a legally binding commitment. The University acknowledges that any gift ultimately distributed may be more or less than this amount.
My/our planned gift is:

My/our planned gift is: Unrestricted (donor's historical giving/areas of interest will be used to align gift with University priorities) Restricted (please consult with the University to ensure that your restriction can be honored)
If restricted, the purpose of my gift is:
Attached is a copy of the relevant portions of the legal documents relating to my/our future gift to the University (optional, but helps the University with future planning).

Attach Files
Donor Recognition

Donor Recognition I/we prefer to remain anonymous. The University may list our names as follows:
Name Name First Middle Last
Signature

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.
Birthdate Birthdate / MM / DD YYYY
Signed Date Signed Date / MM / DD YYYY
Add a second name/signature?

Add a second name/signature? Yes No
Name Name First Middle Last
Signature

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.
Birthdate Birthdate / MM / DD YYYY
Signed Date Signed Date / MM / DD YYYY
The University of New Haven is a 501(c)(3) not-for-profit corporation, with federal tax ID number 06-0761704.

Questions? Contact Lisa Wrubleski, Director of Development, Planned and Major Gifts, at 860.478.2870 or lwrubleski@newhaven.edu

Thank you for your support of the University of New Haven.
Old Fields - Preserve to save old data - Hidden from public view

The University understands that this is an estimate only and that any gift ultimately distributed may be more or less than this amount.

I understand that the University will include my/our name(s) in Ellis C. Maxcy Legacy Society materials. (Neither the type of gift nor the amount will be listed.)
As of this date: As of this date: / MM / DD YYYY
I/we prefer to remain anonymous.

I/we prefer to remain anonymous. I/we prefer to remain anonymous.
Mobile Phone Mobile Phone - ### - ### ####
Birthdate Birthdate / MM / DD YYYY
Birthdate Birthdate / MM / DD YYYY
Spouse’s Name Spouse’s Name First Middle Last
Member Name Member Name First Middle Last
Email
Phone Phone - ### - ### ####
Address Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
I/we have made the following type of legacy gift to the University of New Haven

I/we have made the following type of legacy gift to the University of New Haven A gift in my will or trust for a specified amount A gift in my will or trust for a specified percentage A remainder interest in a charitable trust Designation of the University as beneficiary of an Individual Retirement Account or another type of retirement plan Designation of the University as the beneficiary of a life insurance policy Other (please describe) Other (please describe)

Ellis C. Maxcy Legacy Society Commitment Form

Ellis C. Maxcy Legacy Society Commitment Form

The University of New Haven is a 501(c)(3) not-for-profit corporation, with federal tax ID number 06-0761704. Questions? Contact Lisa Wrubleski, Director of Development, Planned and Major Gifts, at 860.478.2870 or lwrubleski@newhaven.edu Thank you for your support of the University of New Haven.

Old Fields - Preserve to save old data - Hidden from public view

The University of New Haven is a 501(c)(3) not-for-profit corporation, with federal tax ID number 06-0761704.

Questions? Contact Lisa Wrubleski, Director of Development, Planned and Major Gifts, at 860.478.2870 or lwrubleski@newhaven.edu

Thank you for your support of the University of New Haven.