Flynn Heritage Society Form

Date of estate plan or designation

MM

DD

YYYY

I have supported Holy Family Passionist Retreat Center through the following type(s) of deferred gifts: (Please select all that apply.) *

Will or Trust

Individual Retirement Account (IRA) beneficiary (please specify % (if applicable) below).

Donor Advised Fund Beneficiary (please specify the name and of your fund manager, i.e. Fidelity).

Stock/Securities (please provide a description below).

Bank Account Beneficiary (please provide the name of your financial institution below).

Life Insurance Policy (please specify Whole/Universal Life, Term Policy, Death benefit, $ amount below).

Gift of Real Estate (please provide an address and description of the property below).

Charitable Remainder Trust (please provide CRT principal value below).

Charitable Gift Annuity (please provide the full purchase value or total value of combined annuities if more than one, below).

Other gift(s) and/or restrictions (please provide description(s) below).

Is this gift revocable or irrevocable?

This gift is revocable (can be changed).

This gift is irrevocable (cannot be changed).

Is this a percentage or a specified amount?

This gift is a percentage of my estate or account’s value (please specify % stated below).

This gift is a specified amount (please provide monetary value below).

Residual (a bequest of all or part of the remainder of your estate after other planned gifts, debts, taxes, and expenses are paid).

Please tell us about your gift designation. (Please select all that apply.)

I planned this gift in honor of or in memory of someone.

I would like this gift to go to a specific department or program.

Holy Family may use my gift where it will do the most good.

Holy Family recognizes our legacy supporters with membership in The Flynn Heritage Society. By listing your name as part of this group in our publications, we hope you will inspire others to create their own legacy. Please indicate if you would like to be listed, or if you prefer to remain anonymous.

Yes, please list my/our name(s) as part of Holy Family’s publications

No, please do not list my/our name(s).

Name *

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

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