Legacy Gift Notification Form

In the below form, please include any information about your gift that you are comfortable sharing. If you have any questions or need more information, please contact us at 800-535-5577 or Planned_Giving@dfci.harvard.edu.

Dana-Farber recognizes that both the value of deferred gifts and the provisions themselves may change over time. This form does not bind your estate or heirs in any way.

* = Required
*  


*  


   


   


   


 


   


 


   


   


 
Question - Not Required - I/We have included Dana-Farber and the Jimmy Fund as a beneficiary of my/our: (Check all that apply)

   


   


 
Question - Not Required - Is this a percentage or a specified amount?

 
Question - Not Required - Is this gift revocable or irrevocable?

 
Question - Not Required - My/Our gift

   


   


 

(Maximum response 255 chars, approx. 5 rows of text)
 
Question - Not Required - We recognize our legacy supporters with membership in the Dana-Farber Society (DFS). By listing your name, you will inspire others to create their own legacy. My/Our listing preference is:

   


   Please leave this field empty