EmailMeForm
Planned Gift Information
If you have included KPBS in your estate plan, please complete this form so we can recognize your generosity and plan for the future.
Thank you for keeping quality programming thriving in the San Diego region!
This form is not legally binding and will be kept confidential.
Brenda Jones
Planned Giving Program Manager
(619) 594-8787
bjones6@kpbs.org
KPBS Public Media 5200
Campanile Drive
San Diego, CA 92182
Tell us about yourself
Name 1
*
Address
*
Street Address
City
State / Province / Region
Postal / Zip Code
Birthday
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YYYY
Email
Phone
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Name 2
Birthday
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YYYY
Email
Phone
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Will
Tell us about your gift
PLEASE COMPLETE ALL THAT APPLY
Select
Primary beneficiary
Contingent beneficiary
Description of your gift
Estimated value of your gift today
File Upload
*If you are comfortable, please provide us with a copy of your will. You can redact any
information that you wish to keep private.
Trust
Revocable Trust, Charitable Remainder Trust, Charitable Lead Trust
Name of your trust
Date of your trust
MM
/
DD
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YYYY
Select
Primary beneficiary
Contingent beneficiary
Description of your gift
Estimated value of your gift today
File Upload
*If you are comfortable, please provide us with copies of: 1. title page of your trust; 2. page on which KPBS is found; 3. signature page. You can redact any information that you wish to keep private.
Beneficiary Designation
Retirement Plan, Financial Account, Annuity, Life Insurance
Financial institution and type of account
Select
Primary beneficiary
Contingent beneficiary
Percentage
Estimated value of your gift today
File Upload
*If you are comfortable, please provide us with a copy of your beneficiary designation.You can redact any information that you wish to keep private.
Other Means
Managing institution
Name of your fund
Select
Primary beneficiary
Contingent beneficiary
Percentage
Estimated value of your gift today
File Upload
*If you are comfortable, please provide us with a copy of your beneficiary designation.You can redact any information that you wish to keep private.
Donor Advised Fund
Select
Primary beneficiary
Contingent beneficiary
Description of your gift
Names
PLANNED GIVING LEGACY SOCIETY
May we recognize your philanthropy by including you on our planned giving donor wall at the station?
Select
Yes
No, I/we would like to be anonymous
My/our name(s) should display as written below
Additional Benefits
As a legacy society member, you will be invited to our annual planned giving appreciation event and monthly KPBS events. These invitations will be sent to the contact information that you provided.
Signature
Clear
Date Time
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Signature
Clear
Date Time
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