Proposal Request

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About you

Client First Name

Client Last Name

Phone

Client EmailThe client's own email — this is how their record is matched in our system.

Agent EmailOptional. If you are an agent completing this on the client's behalf, enter your own email here.

Client DOB

Tax filing status

Spouse's nameLeave blank if this does not apply.

Spouse's date of birth

Tax filing stateState tax savings depend on this.

Approximate figures are fine. They decide the size of the deduction, so the proposal is only as accurate as these are.

Earned income

W-2, self-employment, business income, and so on.

Approximate net worth

Short-term capital gains

Held one year or less.

Long-term capital gains

Held more than one year.

Loan repayment option

Personal guarantee (UCC1)No personal guarantee — collateralised by life insurance

Most clients choose the second. Ask us if you are unsure — it can be changed before anything is signed.

Your top three charitable inclinationsUp to three causes, organisations, or themes that matter most to you.

Who is your financial advisor?

Who sent you this form?Optional.

Anything else we should know?Optional — proposal preferences or special instructions.

I agree to be contacted by Wealth Excel about my personalised Charitable Gift Financing proposal. I can unsubscribe at any time.

I agree

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