Montreal General Hospital Foundation

Confirming your Legacy Gift

Field Is Required 1. My Legacy Gift - I wish to inform you that my current estate plans include the Montreal General Hospital Foundation as a beneficiary as follows (please check all that apply):

Other. Please describe.

Please specify the amount of your legacy gift or, if your gift is a percentage of your estate, please indicate the estimated value

If you do not wish to specify the amount of your legacy gift today, please indicate this below.

I prefer not to share this amount at this time.

Field Is Required 2. My current plans indicate that my estate gift is:

Other. Please describe.

Field Is Required 3. Recognition - Legacy gifts create a meaningful and lasting impact on the Montreal General Hospital Foundation, and we take great care in recognizing and thanking our donors. We would be honoured to welcome you as a member of our Legacy of Hope Circle.

Yes, please include me/us in the Legacy of Hope Circle and publish my/our name on the recognition list. (To be specified in the section below)
Yes, please include me/us in the Legacy of Hope Circle, but do not publicly recognize me/us.
No, please do not include me/us in the Legacy of Hope Circle.

My/our name(s) should appear as follows:

4. My Information:

Field Is Required Title

Field Is Required First name

Field Is Required Last name

Field Is Required Date of Birth:

Field Is Required Street 1:

Street 2:

Field Is Required City

Field Is Required Province

Field Is Required Postal / ZIP Code:

Field Is Required Email:

Field Is Required Phone Number:

Field Is Required 5. I understand that this declaration of intent will remain strictly confidential and is not legally binding. For greater certainty, it does not replace a will, life insurance policy or any other agreement addressing the same or similar subject matter, whether directly or indirectly. This letter signifies my intention to support the mission of the Montreal General Hospital Foundation and the transformative initiatives in healthcare it supports in alignment with its Charitable Objects.

I confirm that I have read this clause and agree to it.

Field Is Required 6. Confirmation of My Declaration

I understand the above and certify that the information provided is true and accurate.