The Bequest Intention Form

Bequest Intention Form

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This field is for validation purposes and should be left unchanged.

Name(Required)

Email(Required)

Phone(Required)

Spouse Name

Spouse Email

Spouse Phone

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Date of Birth

Spouse Date of Birth

Bequest Amount or Percentage (leave blank if you prefer not to say)

Please use my gift for (if left blank, BTA will use where needed most):

This gift is

In honor of

In memory of

Additional Information

Thank you so much for your bequest. Please let us know how you would like to be recognized in the Frank and Rebekah Guerra Society.

Please keep my bequest anonymous.

Please list my (our) name in the Frank and Rebekah Guerra Society as: