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Charitable
Remainder Trust
Request For Present Value Calculation
To Issue Tax Receipt For Charitable Donation
Purposes
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Name of Donor / Settler: |
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| Gender
of Donor / Settler (circle one): |
Male / Female |
| Date
of Birth of Donor (DD/MM/YYYY): |
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| Amount
Settled: |
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| Date
Settled (DD/MM/YYYY): |
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| Duration
of Trust (circle one): |
Single Life Only
/ Joint
Life |
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| If
Joint Life is selected, please provide: |
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| Name
of Joint Life: |
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| Gender
of Joint Life (circle one): |
Male / Female |
| Date
of Birth of Joint Life (DD/MM/YYYY): |
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| Initial
Account Set-Up Fee, if any ($): |
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| Capital
Distribution Fee, if any (%): |
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This request is made by: |
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| Organization: |
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| Contact
Person: |
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| Telephone
Number: |
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| Fax
Number: |
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| Email
Address: |
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| Signature
of Contact Person: |
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| Date
of Request (DD/MM/YYYY): |
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| Report
Deadline* (DD/MM/YYYY): |
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