USCRI Legacy Gift Intention Form Question Title * 1. Yes, I accept the invitation to join the USCRI Legacy Society. I have provided for USCRI in the following way(s): Will/Trust Life Insurance Beneficiary Retirement Account Beneficiary Donor-Advised Fund Beneficiary Pledge for a Future Gift Other (please specify) Question Title * 2. My gift is: A percentage of my estate A specified amount I prefer to keep the details confidential. Question Title * 3. Approximate gift amount (optional): Question Title * 4. I understand that my commitment to leave USCRI a gift in my estate entitles me to enrollment in the USCRI Legacy Society and special recognition in publications. Please do not publish my name. I wish to remain anonymous. Yes, USCRI may publish my name. Please list me/us as: Question Title * 5. Your Contact Information Name Address Address 2 City/Town State/Province ZIP/Postal Code Email Address Phone Number Done