Letter of Intent

I/we wish to support the “forward in faith . . . . . enriching lives capital
campaign with a commitment of $ . This gift is intended to construct, renovate
and expand St. Luke’s Home, Dickinson, North Dakota.

Commitment

This commitment, at my discretion, is payable over the next five (5) years, and will be fulfilled as noted below:
Amount Pledged

Less Payment Attached

Balance

Payment Method

Please bill me:     Quarterly      Semiannually      Annually
Beginning:       
                              
Special Instructions: 

Checks should be made payable to:  St. Luke’s Foundation, 242 10th Street West, Dickinson, ND 58601-3997. 
All gifts are deductible for income tax purposes within the limits prescribed by law. 
Our tax identification number is 45-0409966.

  Please contact me regarding the transfer of assets or alternate methods of payment

My employer/my spouse’s employer has a matching gift program — please contact me

    for details.  

This intention is subject to modification if changed conditions should warrant.  It is understood this
does not obligate my family or my heirs, although they may desire to complete the payments knowing
of my interest in this project.  It is my serious intention to carry out the foregoing plan to support the
work of the St. Luke’s Home.  It is also understood I may increase the gift I have indicated
if I choose to do so.

 
Address: