Perpetual Fund Society CONFIDENTIAL Thank you for your interest in making a lasting gift to protect California’s environment through the Planning and Conservation League. When you complete this form, you will be a member of the Perpetual Fund Society. The Society consists of people who are kind enough to name the Planning and Conservation League in their estate or living trust plans. We ask for this information about your plans to help ensure that your wishes are accomplished. This is especially true if there are any restrictions or special requests for the use of your gift. All information about your plans will be retained in PCL’s confidential files. Please note that this is NOT a legal document or binding pledge. Name _______________________________ Birth date: _________ Spouse/Partner ________________________Birth date: _________ Address ________________________________________________ _______________________________ Zip _____________ Telephone: _________________ Email: ______________________ PCL is included in my/our estate in the following manner: Outright bequest in will or living trust (such as a specific amount, asset, or item) Percentage of estate Contingent bequest Real estate Trust created in my will IRA or other pension plan Life insurance Other, please describe: ________________________ I would be proud to be acknowledged in PCL publications. Please list my/our name as follows: __________________________________________ I/We prefer to remain anonymous. I would like to direct my gift to the following Perpetual Fund account: Jerry Meral Chair for Leadership: The purpose of this restricted account is to use the revenue generated to attract and retain highly qualified, professional staff, including the Executive Director. 21st Century: The purpose of this unrestricted account is to use the revenue generated to secure the future and continuity of PCL by providing general operating support. A donor may designate a restricted account to support a specified field of interest. The purpose of a donor designated, restricted account is to use the income generated to support individual issues related to a specified field of interest within the environmental and/or conservation fields. Such restricted gifts must be reviewed and approved by the PCL Board prior to acceptance. The Board reserves the right to decline restricted gifts. To help ensure your wishes are accomplished, please describe your future gift: Exact language of provision: (optional) Please write in the space below or attach a copy of the provision or page on which the provision is contained. It is not necessary to provide a copy of the entire will or estate plan. Sometimes we are asked if commitment in a will can be made binding. Should you wish to make such a commitment, please call us to find out how to accomplish your objective. Estimated value of the provision: (optional) Please provide a good faith estimate of the dollar value as of the date this form is signed. (Your estimate is important as the Board of Directors strives to make plans for the future.) $ _____________ Your signature here verifies only that the above information is accurate as of this date. PCL recognizes that values of deferred gifts as well as the provisions themselves may change over time. Should you update your gift plans, you may want to ensure that any provision for the Perpetual Fund Society is directed to the “Planning and Conservation League”. Including such language makes it easier for your gift to be put to the use you intend. Thank you and welcome to the Perpetual Fund Society! Signature _________________________________________ Date _______ Signature _________________________________________ Date _______ The Planning and Conservation League Tax ID number: 94-1600890 If you have questions about this form or would like to discuss your plans, we would be glad to assist you. Please call or email us at (916) 313-4521 or rharris@pcl.org.