Declaration of Intent

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Declaration of Intent It is my/our desire that the following In keeping with Jewish tradition, I/we wish to share my/our blessing community partner organization(s) with others. Therefore, I/we make this Declaration of Intent to help benefit from my/our gift: provide for the Jewish community of tomorrow. o Akiba-Schechter Jewish Day School o I/we intend to Create a Jewish Legacy and will formalize o Am Yisrael Conservative Congregation my/or gift within ___ months. o Arie Crown Hebrew Day School o I/we have already done so but haven’t shared the information o Bernard Zell Anshe Emet Day School with the benefiting Jewish Organizations. o Beth Emet The Free Synagogue o Chicago Jewish Day School o Chicago Sinai Congregation My/Our legacy gift in the approximate amount of $ _________________ o CJE SeniorLife was completed through (check one): o Congregation Beth Shalom o Bequest/Will o Real Estate or Business Interest o Congregation Etz Chaim of DuPage County o Life Insurance o Charitable Gift Annuity o Hebrew Theological College o Retirement Plan Assets (IRA) o Donor Advised Fund o Hillel Torah North Suburban Day School o Charitable Remainder Trust o Other _________________________ o Ida Crown Jewish Academy o Jewish Child & Family Services o Jewish Community Centers of Chicago (JCC Chicago) ____________________________________________________________________________________________ DATE o Jewish Women’s Foundation of Metropolitan Chicago ____________________________________________________________________________________________ o Maot Chitim of Greater Chicago PRINT NAME SIGNATURE o North Shore Congregation Israel ____________________________________________________________________________________________ o North Suburban Synagogue Beth El NAME(S) FOR FORMAL RECOGNITION o o SHALVA I/we would like my/our gift to remain anonymous at this time. o Sinai Health System ____________________________________________________________________________________________ o Solomon Schechter Day School ADDRESS of Metropolitan Chicago o Temple Beth-El ____________________________________________________________________________________________ CITY, STATE, ZIP o Temple Chai o Temple Jeremiah ____________________________________________________________________________________________ HOME PHONE CELL PHONE o Temple Sholom of Chicago ____________________________________________________________________________________________ Please return this Commitment form to the EMAIL community partner organization named above, or mail to the Jewish United Fund/ Jewish Federation of Metropolitan Chicago, 30 S. Wells St., Chicago, IL 60606, to the o You have my/our permission to share my/our legacy commitment attention of Naomi Shapiro. with the designated organizations..

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