Planned Gift Information

This is a confidential record. It helps Creative Clay ensure that your wishes are carried out. Please use the correct legal language to arrange your gift. Provisions should be designated to “Creative Clay, Inc.” EIN 59-3338595.

Briefly describe why you are leaving a legacy for Creative Clay

Name

First Name

Last Name

Birth Date

MM

DD

YYYY

Spouse's Name

First Name

Last Name

Birth Date

MM

DD

YYYY

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Email

Phone

(###)

###

####

Documentation to establish my gift was signed on:

MM

DD

YYYY

My gift will be made in the following way:

Provisions in my will

Retirement plan assets – beneficiary designation for 401(k), 403(b), or IRA

Life Insurance

Other

If you chose "Other" please explain here:

A credible estimate of the current value of the gift is:

Family member or Executor name and contact information (when applicable):

Attorney or Estate Planner name and contact information (when applicable):

Welcome to our Visionary Society! Through the Society, we recognize and celebrate you and other generous and caring people who have made planned gifts to support artists with disabilities and neuro-differences. Please check one:

I understand that announcing this gift may motivate others to give and I am willing to be publicly acknowledged as a member of the Visionary Society.

I prefer that my membership in the Visionary Society not be listed or publicly acknowledged.

Please consider sending a copy of your planned gift document to to us, for our records.

Please discuss your planned giving intentions with your professional advisor and seek legal counsel when needed. You also understand that completion of this form is not intended to be legally binding, but notification of intent. Your planned gift documentation may make your commitment binding or irrevocable if you choose to do so. If your planned gift intentions should change in the future, please notify Creative Clay.