Planned Giving Declaration of Intent

Gift Notification - Planned Giving Declaration of Intent
The information you provide here will ensure that our records are accurate and that we use your gift in the way that you intend. This is not a binding legal document, and your information will be kept confidential. If you have any questions, please contact our Director of Individual Giving, Sara Shaw Meyer at (651) 251-1242 or sara.shawmeyer@girlscoutsrv.org.

If you prefer to notify us offline, download a paper version of the Planned Giving Declaration of Intent Form.
As an expression of my/our commitment to the mission of building girls of courage, confidence, and character, who make the world a better place, I/we desire to provide for the future well-being of Girl Scouts of Minnesota and Wisconsin River Valleys through a provision in my/our estate plans.

I/we take pleasure in declaring my/our intention to become a member of the Juliette Gordon Low Society by establishing the following estate commitments (please check all that apply):
Yes, I/we have named Girl Scouts of Minnesota and Wisconsin River Valleys in my/our:

Will or Trust Provision Life Insurance Beneficiary Charitable Trust Retirement Plan Assets IRA Beneficiary Donor Advised Fund
I/We wish to inform Girl Scouts of Minnesota and Wisconsin River Valleys, for long-term planning purposes only, that the current value of my/our future gift is:
This is OPTIONAL and always kept confidential. If your gift is a percentage of your estate, please indicate the approximate value.
I/We understand that by stating an amount my/our estate is not legally bound by this statement and that I /we may choose to add, subtract, or revoke this bequest at any time, at my/our sole discretion. *

Yes, I understand.
I/We would like this gift to support: *

Area of Greatest Need Endowment
Girl Scouts River Valleys recognizes our incredibly generous legacy supporters with membership into the Juliette Gordon Low Society. By listing your name as part of this group in our publications, we hope you will inspire others to create their legacy of support for girls becoming leaders. Please let us know if you would like to be listed or if you prefer to remain anonymous. (choose one) *

You may publish my/our names in your list of Juliette Gordon Low Society members as a motivation for others to leave a future gift to Girl Scouts of Minnesota and Wisconsin River Valleys. I wish to remain anonymous.
Please list my/our name(s) in publications as:
Estate/Family Primary Contact Information
Name *

First Name Last Name
Email *
example@example.com
Primary Phone Number *

Area Code Phone Number
Secondary Phone Number

Area Code Phone Number
Primary Phone Number Type *

Mobile Work Home
Secondary Phone Number Type *

Mobile Work Home

Address *

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Electronic Signature

By entering today's date and your signature you acknowledge that the information provided is accurate. This is not a binding legal document, and your information will be kept confidential.
Signature *
Date *
Should be Empty:

Gift Notification - Planned Giving Declaration of Intent

Estate/Family Primary Contact Information

Electronic Signature