| Evergreen Acorn
Plan Advice Form |
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| Plan name or number: |
________________________________________ |
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| Advice
Area A |
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| I hereby advise
Evergreen to invest Endowment Funds as follows: |
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| Investment Options: |
(Please pick one
below) |
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[ ] |
Money Market/CD |
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--OR-- |
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[ ] |
Equity Based Investments |
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| Advice
Area B |
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| I hereby instruct
Evergreen to recognize the following party as the new Endowment
Advisor |
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| Effective: |
___________________________________________________________ |
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(Please enter date or phrase such as
"upon my death or legal incapacity".) |
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| Name: |
______________________________ |
| Address: |
______________________________ |
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______________________________ |
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______________________________ |
| Phone: |
(_____) _______________________ |
| E-mail: |
______________________________ |
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| Advice
Area C |
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| I hereby instruct
Evergreen to provide for the following Beneficiaries: |
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| Tax Qualified Organization |
Distribution Percentage |
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| ________________________________________ |
__________% |
| ________________________________________ |
__________% |
| ________________________________________ |
__________% |
| ________________________________________ |
__________% |
| ________________________________________ |
__________% |
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| For Advice
Areas A, B, and/or C above, I certify that I am the Endowment
Advisor and therefore have legal standing to provide the above
advice. |
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| _________________________ |
_________________________ |
_________________________ |
| Endowment
Advisor Signature |
Print
Name |
Date |
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