NPR News and Cultural Arts
  for the Central Valley

Declaration of Intent

Print out and mail the following form to:

Development Department
FM89, Valley Public Radio
3437 W. Shaw, #101
Fresno, CA 93711

my will
a trust agreement
a life-insurance policy
other:

in the approximate amount of $
(indication of amount or percentage is optional)

We would like to extend an invitation to those who have included White Ash Broadcasting, Inc. for benefit of FM89, Valley Public Radio in their will or beneficiary arrangement to join the Legacy Society as our way of thanking you for your thoughfulness.
Yes, please include me as a member
Yes, please include me as a member but I wish to remain anonymous

Though this letter of intent is an expression of my current plans, I understand that I may modify or revoke it and that it is not a legal obligation binding on me or my estate.

I give I do not give you permission to include my name on your list of planned gift donors, which will be printed in Valley Public Radio publications such as the annual report.

If Valley Public Radio has permission to include your name, please indicate below how you would like to be listed:

Signature		Date