The Western Pennsylvania Conservancy: Step 4: Request a Personal Account Illustration

Step 4: Request a Personal Account Illustration.

Instructions: Just fill out the form below and press "SEND" to receive a personalized account illustration from the WPC Development Office that details all of the benefits of your gift plan or plans or print this form and mail to: Director of Development, 209 Fourth Avenue, Pittsburgh, PA 15222. Please note that your request is strictly confidential.

Type of Plan (choose up to two):
Charitable Gift Annuity
Charitable Lead Trust
Charitable Remainder Trust
Bequest
Other

Amount of gift:

Asset type:

Estimated cost basis of asset:

Dates of birth of income beneficiaries (if applicable):
Beneficiary #1:
Beneficiary #2:

Please send my personal account illustration by:
Mail E-mail Fax

Contact Information:

Name
Address
City
State
Zip
Phone
Fax
E-mail

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