Planned Giving Please fill out this form in its entirety and submit using the button below. This form is for Halo House information only and by submitting this form the donor is under no obligation to leave a planned gift to Halo House. Name* First Last Company/Organization Phone*Email* Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code I am interested in leaving a legacy gift to Halo House through the following giving vehicles.*Please check all that may apply. This is for Halo House informational purposes only and by checking the boxes the donor is under no obligation to leave a planned gift to Halo House. Bequest Life Insurance Policy Beneficiary Retirement Plan Beneficiary IRA Rollover Charitable Gift Annuity Charitable Remainder Trust May we contact you regarding this form?* Yes, please call or email me No thanks, I will contact my personal financial advisors or tax attorney Additional CommentsCAPTCHAPhoneThis field is for validation purposes and should be left unchanged.
