STATEMENT OF INTENT FOR
FAYETTEVILLE STATE UNIVERSITY
As documentation of our future INTENT for Fayetteville State University, we are pleased to report that we
have made a gift or estate provision for the benefit of University/Foundation.
Bequest via will(s) or personal trust(s)
Charitable remainder trust
Life insurance naming University/Foundation as owner and beneficiary
Retirement plan beneficiary designation
Other __________________________________________________________________________________
It is understood that values are subject to change, but we estimate the current value of our provision to be
approximately $ ________________________________________________________________________
We wish our future gift to be used for:
The area of greatest opportunity within the University _______________________________________
Other (Specify: academic department or degree program for scholarships, fellowships, research,
faculty/staff support, athletics, special projects, etc.)
___________________________________________________________________________________________
___________________________________________________________________________________________
It is understood that these statements and estimates are offered solely to assist Fayetteville State University record
and project future financial support and gift expectancies. THIS IS NOT A BINDING LEGAL OBLIGATION UPON
THE DONOR OR THEIR ESTATE AS TO THE VALUE OR RECEIPT OF THE PROVISION(S) HEREIN
REVEALED AND DESCRIBED. ALL INFORMATION IS FOR INTERNAL USE ONLY.
A copy of the provision is attached or will be sent when it is executed.
(Membership in the Bronco Legacy Circle has a $25,000 minimum)
We do not wish to publish information about this planned gift.
Birth Date(s): ____________________________________
_______________________________________
Donor’s Signature ________________________________
Date __________________________________
Donor’s Signature ________________________________
Date __________________________________
Office of Major Gifts/Gift Planning
Division of Institutional Advancement; Fayetteville State University
1200 Murchison Road
Fayetteville, North Carolina 28301
Ph: (910) 672-1729 Fax: (910) 672-1663