Planned Gift Form

Date: ______________

I have made a Planned Gift to The Legacy Fund of The Columbus Foundation.

_____  as a beneficiary in my Last Will and Testament

_____  as a beneficiary on a life insurance policy

_____  as a beneficiary on a retirement plan

_____  as a beneficiary on a financial account

_____  other planned gift

You may provide more information on the nature of your planned gift, if you wish to do so.

 *  *  *  *  *

_____  I wish my planned gift to be listed as being made by an anonymous donor.

                                                            - or-

_____  I consent to have my name publicly acknowledged for my planned gift.

By signing this consent I agree to allow my name to be publicly acknowledged as having made a planned gift to The Legacy Fund of the Columbus Foundation.   I acknowledge that my name will be listed without reference to the amount or type of planned gift that I have made.   I also consent to have my name publicly listed on the Planned Donor page of The Legacy Fund website.  By signing this consent I am not legally bound to make the planned gift that is referenced, and I am not prohibited from amending, modifying or revoking my planned gift.  My official name is listed as:

____________________________________ (please print exact spelling that you wish to use.)

_______________________________          __________

Name                                                              Date

  You may forward this form directly to a board member of The Legacy Fund, or you may mail it to…

The Legacy Fund of The Columbus Foundation, 1234 East Broad Street   Columbus, Ohio   43205.