Please contact our office at 812-424-5536 and we will prepare a complete Charitable Annuity Proposal for your approval .Once you have reviewed and are satisfied with your proposal, please print, complete the form and mail to the address at the bottom of the application.

Charitable Gift Annuity Application

I wish to enter into a Charitable Gift Annuity Agreement with the Catholic Foundation of Southwestern Indiana, Inc.

This is to be a:      

          Single-Life Agreement (minimum $10,000)

         Single-Life Deferred Agreement (minimum $10,000)

         Two-Life Agreement (minimum $10,000)

         Two-Life Deferred Agreement (minimum $10,000)

If deferred, annuity payments are to begin in the year ________.

(Must be at least one year after date of this application.)

Please send payments:                    Annually                 Semi-Annually                 Quarterly

Gift is to be used for:

         Endowment ______________________________________________________

         Area of greatest need as determined by Board of Directors of the Catholic Foundation.

I have read the sample annuity agreement and other information provided to me by the Catholic Foundation of Southwestern Indiana, Inc.  I fully understand that the Charitable Gift Annuity Agreement of the Catholic Foundation of Southwestern Indiana, Inc. is irrevocable and the individuals I designate will receive payments for life and that the remainder will be used for charitable purposes. 

DONOR INFORMATION:

Name:

Address:

Phone:                                                                                              Email:

Signature of Donor:                                                                                                                            Date:

Signature of Spouse (if joint or community property):                                                              Date:

BENEFICIARY INFORMATION:

Payments are to be made for life to FIRST INCOME BENEFICIARY:

Name:

Address:

Phone:                                                                                             Date of Birth:

Social Security Number:

(To be completed only for two-life agreements.)

Payments are to be made for life to SECOND INCOME BENEFICIARY:

Name:

Address:

Phone:                                                                                             Date of Birth:

Social Security Number:

Cash Gifts:

Check enclosed in the amount of    $________________________________________

Checks should be made payable to: The Catholic Foundation of Southwestern Indiana

Gifts of Stock:

The following described stock ___________________________

Number of shares _________________

In the case of stock, please contact The Catholic Foundation of Southwestern Indiana, Inc. for instructions before transfer is made.

Please complete this form and return to: