A Gift to Lahey Clinic
A practical way to make a planned gift to Lahey Clinic is to include Lahey in your will or revocable trust, or as a beneficiary of your retirement plan or life insurance. If you have already made a provision to include Lahey in your financial planning, please notify us by completing and returning this document. By documenting your bequest intention, Lahey will have an opportunity to recognize your generous support in your lifetime.
Information provided to signify your bequest intention to Lahey will remain completely confidential unless you authorize Lahey to publicize your gift. Lahey understands that all bequest provisions are revocable, and any intentions stated here are not binding on you or your estate.
I have made revocable gift commitments for Lahey Clinic as follows (check all that apply):
Bequest Approximate value: $_______________
Life Insurance Policy Approximate value: $_______________
IRA or other retirement plan Approximate value: $_______________
Other asset Approximate value: $_______________
Recognition (Select one.):
I/we accept membership into the Dr. Charles A. Fager Legacy Society (recognition society for donors who have included Lahey Clinic in their estate plan). Please publish my/our name(s) among your lists of Dr. Charles A. Fager Legacy Society members.
Please clearly print the text as it should appear: _____________________________________________
Please do not list my/our name(s) publicly.
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Signature
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Date
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Name (please print)
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Signature
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Date
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Name (please print)
Contact information—representative of my estate:
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Name
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Telephone
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Role
________________________________________________
Email
I have attached documentation from my will, retirement plan, life insurance policy, or trust.
If your gift is for a percentage of your estate, rather than a fixed amount, Lahey will be happy to use your good faith estimate of the current value based on this percentage. While not required, you may wish to include a copy of the relevant portion of related documents.