The American Foundation: New Case Information Form

New Case Information Form

The information requested in this form will be used to help determine the proper charitable estate planning tools to achieve the donor’s objectives. After this confidential questionnaire is completed and returned to The American Foundation™, the development staff will prepare and forward proposed illustrations to the professional tax advisor. Please allow up to 2 business days for a return illustration. Fax completed form to: 602-955-4707 or email: newcase@americanfoundation.org.

Today’s Date

Professional Tax Advisor Section

Name	Title
Phone	Fax
Address	Company
Address	E=mail
City, State, Zip	Mobile

Donor Section

Name	Spouse
Home Phone	Business Phone
Address	Email
	Donor DOB	Age
City, State, Zip	Spouse DOB	Age

Approximate Net Worth		Approximate Income (AGI)

Family Members Involved In or Receiving Benefits from Estate Plan	Age or DOB	Family Members Involved In or Receiving Benefits from Estate Plan	Age or DOB

*If asset is held by a corporation, please specify which kind (i.e. C Corp, S Corp, LLC, etc.). Use additional sheets if necessary.
Projected long term annual return of charitable trust or foundation (%)

For American Foundation™ use only. (Recommendations/Illustrations)