Planned Giving Form

The Legacy Society, FSR’s planned giving society, is a community of thoughtful supporters who are leaving a legacy towards finding a cure for sarcoidosis.

If you would like to create a legacy for the sarcoidosis community by including the Foundation for Sarcoidosis Research in your estate plans, please complete the form below or complete and return the form as a PDF.

The Legacy Society - Planned Giving Commitment Form

Name*
First Last
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Email*
Phone*
Recognition*
- Please recognize me/us in the Legacy Society
- I/we wish to remain anonymous
Please recognize me/us in the Legacy Society as:*
Please indicate your planned gift below:*
To make multiple choices, please hold Ctrl on your keyboard.
Other:*
This gift will be:*
Please make the appropriate choices and describe in the fields that appear below. To make multiple choices, please hold Ctrl on your keyboard.
A specific amount:*
A gift of a specific asset:*

Please describe.
A percentage of the residuary of my estate, trust, or retirement plan:*

Please include what percentage of asset(s) you intend to give to FSR.
Please add any details you wish to share:*
All information provided will be kept in the strictest confidence and will be used for internal planning purposes only. We understand that you may need to use estimates rather than exact figures.
Purpose of the planned gift to Foundation for Sarcoidosis Research:*
- Unrestricted gift to provide maximum flexibility for FSR to use for greatest need.
- For a specific purpose
For a specific purpose:*
Accept and Submit*
- I accept
Completion of this form is not intended to be legally binding, but notification of intent. Please discuss your planned giving intentions with your professional financial advisor. Foundation For Sarcoidosis Research is a tax-exempt nonprofit organization recognized by section 501(c)(3) of the Internal Revenue Code. Tax ID #36-4378232. Contributions are deductible as allowed by law.

The Legacy Society - Planned Giving Commitment Form

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