The Brian Mendell Legacy Giving Society

We realize that many people who plan to support Shatterproof through their estate and/or financial plans prefer to keep their intentions private. However, by letting us know of your plans, we can thank you during your life, and confirm that we are able to fulfill your stated intentions. Please know that completing this form is non-binding — we understand that you may change your plans at any time. Please also know that all information you share with us is kept strictly confidential.

Confidential Personal Information

First Name

Last Name

Spouse First Name

Spouse Last Name

Street Address

City

State

Postal Code

Phone

Your birthdate

Spouse's birthdate

Your Gift Intention

Please provide the following information and attach a copy of the documentation or appropriate language from your will or trust, if available. Please complete all that apply.

I/We want to support the mission of Shatterproof through a planned gift below:

I/We have included a bequest for Shatterproof in my/our will or living trustI/We have named Shatterproof as a beneficiary of an assetI/We have named Shatterproof as a revocable beneficiary of a charitable remainder trustI/We have named Shatterproof as an irevocable beneficiary of a charitable remainder trust

Which assets have you named Shatterproof the beneficiary of?

Retirement Plan BankInvestmentOther Financial AccountOther

Other asset

Will the anticipated value of your gift be a flat amount or a percent of your estate?

AmountPercent

What is the expected amount?

What percentage of your estate?

Please provide a general description of the gift provision (such as, asset to be donated if other than cash or securities, how gift is to be used – restricted or unrestricted, etc.):

Would you like to be included in listings of planned gift donors?

YesNo

Please indicate how you would like your name(s) to appear in the Brian Mendell Giving Society.

Contact Information