1. Proposed Foundation Name * |
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2. Alternative Foundation Name |
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3. Primary Purposes of Foundation * |
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4. Founder (do not fill in if you ordered Nominee Founder) |
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5. Foundation Council Members (do not fill in if you ordered Nominee Foundation Council) |
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6. Officers (do not fill in if you ordered Nominee Foundation Council) |
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7. Individual requiring Power of Attorney (if you ordered Nominee Foundation Council) |
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8. Protector (optional) |
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9. Beneficiaries * |
First Beneficiary |
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Name (First, Middle, Last)
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% of Interest
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Additional Beneficiaries (Names, % of Interest)
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10. Any Additional Information |
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11. Source of Information about our Company |
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12. Your contact information * |
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