Heritage Society Gift Intent Form

Thank you for your interest in joining the other visionary supporters in Iowa Public Radio's Heritage Society. We are grateful that you value IPR and want your legacy to impact future generations.

We welcome you to share your intentions with us by completing the information below.

I/We would like to learn more about joining the Heritage Society and gift options at Iowa Public RadioI/We have included Iowa Public Radio in our future plans.

Donor Information

Name (Last, First)

Spouse or Partner's Name (Last, First)

Date of Birth

Spouse/Partner Date of Birth

Street Address

City, State, Zip

Phone

Gift Information

The gift has an estimated value of:

Estimated gift amounts are optional and strictly confidential. We understand that this amount may change over time, or even be revoked. This information is for internal planning purposes only.

The gift is in my/our:

Will	Retirement Account	Charitable Remainder Trust
Revocable Trust	Life Insurance Policy	Other

Other giving instrument:

It's our intention to be good stewards of future gifts.

All Heritage Society gifts, unless designated otherwise, allocate a portion to Iowa Public Radio's general operating activities. The remaining portion goes to our Second Century Fund, a semi-restricted endowment designed to provide a growing source of income managed at the direction of IPR's governing board.

Recognition Preference

You may use my/our name(s) in lists of Heritage Society members to help inspire others to make a similar choice.I/We wish to remain anonymous at this time.

My/our name(s) should appear as (e.g. Jane D. and John Q. Smith):

Signatures

Signature

Signature Date

IPR Signature

IPR Signature Date

Please consult your financial adviser or contact Andrea Hansen, Development Director at IPR, at 515-725-1701 or ahansen@iowapublicradio.org.

Contact Information