Legacy Intent Directive Form

The Community Foundation of Southeast Kansas

Legacy Intent Directive Form

I/We ______wish to provide guidance to the governing board of the Community Foundation of Southeast Kansas (CFSEK) regarding the ultimate use of my/our planned gift(s). I have established the following type of planned gift by designating CFSEK as a beneficiary in my:

( ) Will/Bequest ( ) Retirement Plan / Life Insurance ( ) Charitable Gift Annuity ( ) Charitable Trust

The approximate value of my planned gift in today’s dollars is ______. (Optional)

It is my desire that the proceeds of my planned estate gift(s) be used for the purpose stated below:

(Please designate your preference below.)

_____ 1. Unrestricted: I wish to have the proceeds placed in a permanent endowment where the principal will be preserved and only the interest, according to CFSEK policy, will be distributed at the discretion of the CFSEK board. Unrestricted funds allow CFSEK maximum flexibility to direct funds where they are most needed in our community at the time, which could change dramatically 50 years from now!

_____ 2. Field of Interest: I wish to have the proceeds placed in a permanent endowment where the principal will be preserved and only the interest, according to CFSEK policy, will be used to support an area(s) of my interests identified below.

_____ 3. Designated: I wish to have the proceeds placed in a permanent endowment to establish a specific named endowment fund where the principal will be preserved and only the interest, according to CFSEK policy, will be used to support a charity/charities of my choice identified below. In the event a particular charity ceases to exist, an organization with a similar cause will be substituted.

What charity/charities or field of interest do you wish to support? See CFSEK’s Family of Funds list…

______

Name of Executor / Attorney / Financial Advisor and contact information: ______

______

This directive may be changed at any time; please let us know of any developments.

Signature ______ Date ______

Witness ______ Date ______

Community Foundation of Southeast Kansas PO Box 1448 Pittsburg, Kansas 66701 620.231.8897