STATEMENT OF WISHES – SUCCESSION AND BEQUESTS

Use this form to give us a broad indication of how you would like your Fund managed after you are no longer able to be actively involved.

Your responses are in no way binding and you are welcome to amend them at any time.

If you would like to discuss the form or need assistance completing it, please contact our Fund and Client Services Team on (03) 9412 0412 or community@communityfoundation.org.au

YOUR DETAILS

Your name *

Email *

Phone Number *

Fund name *

FUTURE OF THE FUND

In the event that I am no longer able to manage my Fund: *

I would like the fund to be continuedI would like the fund to be closed

Who will manage the Fund? *

I/we wish to nominate one or more successor advisor/s to the fund.I/we wish Australian Communities Foundation to manage the fund and make distributions in line with the fund’s stated areas of interest.

Successor advisor authority *

I/we wish the successor advisor/s to adhere to stated fund areas of interest.I/we agree to successor advisors changing the fund areas of interest in line with community need and in consultation with the Australian Communities Foundation team.

Successor details

Title

First Name *

Last Name *

Suffix (e.g. PhD,OAM)

Preferred Name

Year of Birth

Gender (optional)

FemaleMaleNon-binaryOther

Personal pronouns (optional)

Address *

Phone *

Email *

Relationship to Fund Advisor *

I/we have informed my Successor of my intentions expressed in this Statement of Wishes *

YesNo

I would like to nominate a second successor

Second successor details

Title

First Name *

Last Name *

Suffix(e.g. PhD, OAM)

Preferred Name

Year of Birth

Gender (optional)

FemaleMaleNon-binaryOther

Personal pronouns (optional)

Address *

Phone *

Email *

Relationship to Fund Advisor

I/we have informed my Successor of my intentions expressed in this Statement of Wishes *

YesNo

Fund closure

The Fund will continue as long as its balance is more than $10,000. In the event it falls below this level, we will grant out the balance and close the Fund.

How would you like us to grant out your Fund's closing balance? *

To organisations similar to the ones I have granted to before, and/or in line with the Fund's areas of interestTo the ACF Impact Fund, to support bold, progressive solutions to the biggest issues facing AustraliaAs specifically directed below

Where would you like your closing balance to be granted? *

BEQUEST

Will you leave a bequest to your Fund or the ACF Impact Fund *

YesNoI haven't decided yet

Name of legal representative

Relationship (eg solicitor, executor)

Relevant section of Will, or any other relevant documents

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REVIEW AND SUBMISSION

Anything else you would like to share with us about the future of your Fund

Would you like to review this statement with a member of the Australian Communities Foundation team? *

Yes, please contact me nowYes, but not nowNo thanks, I/we will contact the team if I/we would like to change this statement.

When would you like us to contact you? (eg three months, two years) *

Name of signatory *

Date *

Signature *

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