Statement of Bequest

Personal information

First name Required Field

Middle name

Last name

Dartmouth Affiliation:

Preferred class year

You are eligible for gift recognition credit for your bequest.

Preferred email Required Field

Email

Your preferred email address is what we use to send email messages to you from Dartmouth.

Spouse/partner information (optional)

First name

Last name

Preferred class year

Select the gift type(s)

Gift types Required Field

Gift types Will
Living trust
Charitable remainder trust
Retirement account/IRA
Life insurance policy
Other asset (describe below)

Describe other asset

Enter the estimated value(s) of your gift(s) to Dartmouth

Will amount

Living trust amount

Charitable remainder trust amount

Retirement account/IRA amount

Life insurance policy

Other asset amount

When will Dartmouth receive this gift?

Dartmouth receives this gift after Required Field

Dartmouth receives this gift after My life
The life of my surviving spouse/partner
Other

Spouse's name

Please describe

How will this gift be used?

* Describe restricted use

Attach document

To receive recognition of your gift, please attach the relevant section of your will, trust, or beneficiary designation form.

Files must be less than 10 MB.
Allowed file types: jpg jpeg png pdf doc docx gz tar zip.

Recognition

We periodically publish the names of those who make bequests to inspire others. May we include yours?

Required Field

We periodically publish the names of those who make bequests to inspire others. May we include yours?

Yes, publish my name and gift amount range to inspire others.
No, please don’t publish my name.

THIS IS NOT A LEGALLY BINDING DOCUMENT. Dartmouth recognizes that your plans may change over time; please consider notifying us of future changes.

Questions? Email us or call 1.800.451.4067.