Bequest Intention Form

Date: *

Donor 1 Name: *

First

Last

Donor 2 Name (if applicable):

First

Last

Is the Unitarian Universalist Church of Urbana Champaign (UUCUC) in your estate plans? *

Yes, UUCUC is in my/our estate plans, and I/we wish to share details of those plans
Yes, UUCUC is in my/our estate plans, and I/we do not wish to share details of those plans at this time

If you select to share details of your estate plans, further options for sharing information on this form will be provided.

Do you want to be listed as anonymous?

Yes

Donors' names will be publicly listed unless the Anonymous box is checked.

Address:

Address Line 1

Address Line 2

City

State

Zip Code

Donor 1 contact information
This email address will receive a confirmation email.

Email: *

Phone:

Donor 2 contact information (if applicable)

Email:

Phone:

Details of my/our estate plans concerning UUCUC / Gift(s) via (check all that apply):

If you selected "Other" above, please specify here:

Estimated total of unrestricted gifts (optional):

In honor/memory of:

Estimated total of restricted gifts:

Restricted Gifts: The Board of Trustees of the Church may accept or reject any restricted gift subject to the limits set forth in the Constitution and Bylaws.

Restricted (please explain restrictions or provide a copy of the restrictions):

Other Details/Comments:

UU Church of Urbana Champaign

UU Church of Urbana-Champaign

Sunday Services: 10.15am