The Animal Haven Legacy Society Letter of IntentPlease enable JavaScript in your browser to complete this form.Name 1FirstLastPhoneEmailName 2FirstLastPhoneEmailAddressAddress Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeType of GiftWill/Living TrustRetirement AccountCharitable Gift AnnuityBank or Investment AccountLife Insurance PolicyDesignated FundOtherIf other, please specify the type of gift.Optional: I/we wish to inform The Animal Haven, for long-term planning purposes only, that as of this date, the value of my/our gift is:If your gift is a percentage of your estate, please indicate the approximate present value of that percentage.I/we understand that my/our estate is not legally bound by this letter and I/we can modify my/our estate plan in any way at any time, including to increase, decrease, or eliminate this planned bequest. For legal purposes, The Animal Haven’s 501(c)(3) Tax ID is 06-0735382.I would like my future gift to be used to support:Where it is most neededGeneral Operating FundsThe Endowment FundOtherIf other, please specify what you'd like your future gift to support. Please enroll me/us in The Animal Haven Legacy Society:The Animal Haven may publish my/our name(s) as a member/members of The Animal Haven Legacy Society and place my/our name(s) on the Legacy Society Donor’s Plaque at the shelter. The amount of your gift will not be published.Make my/our gift anonymous until after my/our death(s).Please list me/us asSignature 1 (use your mouse)Clear SignatureDateSignature 2 (use your mouse)Clear SignatureDateSubmit
