Bequest Intention Form

Support through an estate gift/bequest for the mission of Family & Children’s Service of Ithaca may be directed in two ways. Gifts made specifically to the Endowment Fund of Family & Children’s Service of Ithaca support F&CS’s mission in perpetuity by aiming to retain and invest the principle of those funds indefinitely, allowing for a portion of investment proceeds to support annual programs. Alternatively, donors may direct their gift to Family & Children’s Service of Ithaca without restriction, which will result in the F&CS Board’s deciding the distribution of those funds based on current organizational needs, which may include active programs or may result in allocating a portion, or the entirety, to the Endowment Fund. We will honor the donor’s intentions as specified below.

NAME

SPOUSE'S NAME (if applicable)

EMAIL

PHONE NUMBER

STREET ADDRESS

CITY, STATE, ZIP.

I/We direct that my/our gift be distributed as follows:

Endowment Fund of Family & Children's Service of Ithaca (EIN 15-0589039)Without restriction to Family & Children Services of Ithaca (EIN 15-0589039)

Type of Gift

Will/BequestTrust (specify type in box below):Other (please specify below):


If applicable: My gift names Family & Children's Service of Ithaca as:

Primary BeneficiaryContingent Beneficiary

Describe Contingency:


My Gift is:

A specific dollar amount $ (enter amount below):Stated as a % - based on current value, I estimate the above noted gift to be:


I/We understand that this Estate Gift Intention Form is not legally binding but will allow Family & Children's Service of Ithaca, to understand my/our gift intention and recognize my/our future support. I/We agree to inform you should these plans change or should the dollar value of my/our estate potential donation significantly increase or decrease. Family & Children's Service of Ithaca understands that my/our gift intention is revocable.

SIGNATURE 1:

DATE:

SIGNATURE 2 (if applicable):

DATE:

Gift Recognition

I/We wish to remain anonymous.To help Family & Children's Service of Ithaca understand my/our intentions as set forth above, I/We are including the appropriate sections of relevant documents (providing documentation will help to ensure your estate intentions are fulfilled)In recognition lists, I/We would like to appear as follows (insert text in field below):


Please mail your forms/documents to:
Family & Children's Service of Ithaca
127 W. MLK Jr./State Street
Ithaca, NY 14850

For Questions or additional information please contact:
Michelle Thevenin - Director of Development
mthevenin@fcsith.org
(607) 273-7494

Note: We recommend that you consult appropriate legal and tax/financial counsel related to your estate and testamentary plans. Additionally, please know that all details related to your gift will be held in strict confidence.

Additional parties authorized to discuss my bequest are:

NAME:
RELATIONSHIP:

My bequest intentions are detailed currently in my Will or Estate Plan, in the care of:

LAW FIRM or LAWYER'S NAME:
ADDRESS:
PHONE NUMBER:

Please share a copy of this form with your estate planning attorney. Family & Children’s Service of Ithaca, a charitable organization
under the section 501(c)(3) of the Internal Revenue Code, is exempt from federal income taxation. The tax identification number of
Family & Children’s Service of Ithaca is 15-0589039.