I, ________________________________, give, devise, and bequeath to Haven Society: Promoting the
safety of women, children, youth and families, the sum of $_______________or ____________% of the
residue and remainder of my estate, for the sole benefit of Haven Society: Promoting the safety of
women, children, youth and families and its general purposes.
If, in the opinion of the Board of Directors of the Haven Society (hereinafter in this clause referred to as
the “Board”) it should become impossible, inadvisable, or impractical to apply the said fund (principal or
income) for the said purposes, or if the Board is of the opinion that part of the said fund (principal or
income) is not required for said purposes, the Board shall use the said fund (principal or income), or
such part thereof, in such a manner, as in its discretion may deem to be to the best advantage of the
Haven Society: Promoting the safety of women, children, youth and families for other purposes
consistent with the spirit and intent of this bequest.
With my signature below, I give my express permission for Haven Society: Promoting the safety of
women, children, youth and families to deposit my bequest/donation in their (please select one):
o
o
o
General Operations Fund
Building Legacy Fund
Endowment Fund Account
Signature of Donor
Print Name
Dated on ______________________ at ___________________________ (city)
Signature of Witness
Dated on _____________________ at _____________________________ (city)
Print Name