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Donations & Bequests Request Form
D&B Request Form
Indicate all change(s) being requested.
*
Special Withdrawal
Addition
Updated Spending Plan
New Account
Transfer of Existing Assets within a Fund
Closing of Fund
Parish Information
Select your Parish or Intentional Episcopal Communities to autofill available fields. (Parishes are listed by Name, City)
*
All Saint's, Wolcott
All Saints with Christ, Oakville
All Saints, Ivoryton
All Saints', East Hartford
Calvary-St. George's, Bridgeport
Calvary, Stonington
Christ & Holy Trinity, Westport
Christ & The Epiphany, East Haven
Christ Church Cathedral, Hartford
Christ Church Greenwich, Greenwich, CT
Christ Church Tashua
Christ Church, Ansonia
Christ Church, Easton
Christ Church, Guilford
Christ Church, Middle Haddam
Christ Church, New Haven
Christ Church, Norwalk
Christ Church, Pomfret
Christ Church, Quaker Farms
Christ Church, Redding
Christ Church, Roxbury
Christ Church, Sharon
Christ Church, Stratford
Christ Church, Waterbury
Christ Episcopal, Bethany and Woodbridge
Church of the Good Shepherd/Iglesia de El Buen Pastor, Hartford
Church of The Holy Spirit, West Haven
Emmanuel Killingworth
Emmanuel, Weston
Epiphany, Southbury
Episcopal Church in Connecticut, Meriden
Good Shepherd, Orange
Good Shepherd/Immanuel-St. James Chapel, Shelton
Grace and St. John's Church, Hamden
Grace Church, Stafford Springs
Grace Episcopal Church, Windsor
Grace, Hartford
Grace, Old Saybrook
Grace, Yantic
Holy Advent, Clinton
Holy Trinity, Enfield
Holy Trinity, Middletown
Iglesia Betania, Stamford
Immanuel-St. James, Derby
L'Eglise de L'Epiphanie, Stamford
Old St. Andrew's, Bloomfield
Saint Saviour's, Old Greenwich
San Lucas y San Pablo, Bridgeport
St Andrew the Apostle, Rocky Hill
St George's, Bolton
St James Church, Preston
St John's, Bridgeport
St Stephen's, East Haddam
St. Alban's, Simsbury
St. Andrew's, Kent
St. Andrew's, Madison
St. Andrew's, Marbledale
St. Andrew's, Meriden
St. Andrew's, Milford
St. Andrew's, Northford
St. Andrew's, Stamford
St. Ann's, Old Lyme
St. Barnabas, Greenwich
St. David's, Gales Ferry
St. Francis, Stamford
St. Gabriel's, East Berlin
St. George's, Middlebury
St. James Parish, Farmington
St. James, Winsted
St. James' New London
St. James', Danbury
St. James', Glastonbury
St. James', Higganum
St. James's, West Hartford
St. John's, Essex
St. John's, Guilford
St. John's, New Haven
St. John's, New Milford
St. John's, Niantic
St. John's, North Haven
St. John's, Pine Meadow
St. John's, Salisbury
St. John's, Stamford
St. John's, Vernon, CT
St. John's, Washington
St. John's, Waterbury
St. John's, West Hartford
St. Luke's, Darien
St. Luke's, New Haven
St. Luke's, South Glastonbury
St. Mark's, Bridgeport
St. Mark's, Bridgewater
St. Mark's, Mystic
St. Mark's, New Canaan
St. Mark's, Storrs
St. Martin's, Hartford
St. Matthew's, Wilton
St. Michael's, Litchfield
St. Michael's, Naugatuck
St. Monica's, Hartford
St. Paul and St. James, New Haven
St. Paul's on the Green, Norwalk
St. Paul's Parish: St. Paul's Church with Christ Church Chapel
St. Paul's, Brookfield
St. Paul's, Fairfield
St. Paul's, Plainfield
St. Paul's, Riverside
St. Paul's, Shelton
St. Paul's, Southington
St. Paul's, Wallingford
St. Paul's, Westbrook
St. Paul's, Willimantic
St. Paul's, Windham
St. Paul's, Woodbury
St. Peter's Grace, Monroe
St. Peter's South Windsor
St. Peter's-Trinity, Thomaston
St. Peter's, Cheshire
St. Peter's, Hebron
St. Peter's, Milford
St. Peter's, Oxford
St. Stephen's, Bloomfield
St. Stephen's, Ridgefield
St. Thomas, Bethel
St. Thomas', New Haven
Todos los Santos – All Saints', Meriden
Trinity Episcopal Church, Wethersfield
Trinity on the Green, New Haven
Trinity, Branford
Trinity, Brooklyn
Trinity, Collinsville
Trinity, Hartford
Trinity, Lime Rock
Trinity, Litchfield
Trinity, Newtown
Trinity, Portland
Trinity, Seymour
Trinity, Southport
Trinity, Tariffville
Trinity, Torrington
Trinity, Trumbull
Zion, North Branford
Parish Street Address (Line 1)
*
Parish Street Address (Line 2)
Parish City
*
Parish State
*
Parish Zip Code
*
The auto filled information above from the Annual Parish Survey is correct.
*
Yes
No
Please correct any errors in the fields above and continue on completing the form.
Primary Contact
Primary Contact Name
*
Primary Contact Name
First
First
Last
Last
Primary Contact Email
*
Primary Contact Phone
*
Primary Contact Relationship to Parish
*
Clergy
Warden
Treasurer
Clerk
Special Withdrawal
Account Name for Special Withdrawal
*
Account Number for Special Withdrawal
*
Five (5) Digit
Type of Account Invested In
*
Balanced Fund
Values Investing Fund
Does the account have restrictions?
*
Yes
No
Account Restriction for Special Withdrawal
*
Amount requested for Special Withdrawal
*
$
Reason for Special Withdrawal
*
Capital Expenses
Operating Expenses
Our parish has a current ACH on file
*
Yes
No
Certification of Vestry Meeting, including vote to approve special withdrawal of funds from account designated above.
*
Drop a file here or click to upload
Choose File
Maximum file size: 1MB
D&B Authorization Form
*
Drop a file here or click to upload
Choose File
Maximum file size: 1MB
New/Updated ACH
Drop a file here or click to upload
Choose File
Maximum file size: 268.44MB
Additions
Account Name for Addition
*
Account Number for Addition
*
Type of Account
*
Balanced Fund
Values Investing Fund
Does the account have restrictions?
*
Yes
No
Account Restriction for Addition
*
Amount to be added
*
$
Transfer of Existing Assets with a Fund
Account Name for Transfer of Assests
*
Account Number for Transfer of Assests
*
Does the account have restrictions?
*
Yes
No
Account Restriction for Addition
*
Move Existing Assets
*
From
To
Balanced Fund
*
From
To
Values Investing Fund
*
From
To
Please provide any additional information about this transfer of assets.
New Account
Name of New Account
*
Ex. General Fund
Describe origin of new account
*
For example: gift of donor for detailed purpose; bequest from deceased member; etc.
Type of New Account
Balanced Fund
Values Investing Fund
Restrictions on New Account
*
Donor Restricted
Temporarily Restricted
Unrestricted
Provide additional information about account restrictions.
Copy of original documents detailing gift
*
Drop a file here or click to upload
Choose File
Maximum file size: 1MB
For example: gift letter, copy of will, etc.
D&B Assigned Signatories Form
*
Drop a file here or click to upload
Choose File
Maximum file size: 1MB
Spending Plan
The Episcopal Investment Funds offers your church the option of setting a regular schedule of distributions from your account. Learn more about how spending plans are calculated annually.
Select your spending plan
*
We elect to choose no spending plan and have all income of our accounts reinvested.
We elect to choose a percentage-based spending plan to be distributed monthly.
We elect to choose a dollar-specific spending plan to be distributed monthly.
We elect to receive only income from this account.
Percentage-Based Spending Plan
*
1% annually
2% annually
3% annually
4% annually
5% annually
% annually
% annually
Calculated annually, distributed monthly.
Amount to be received monthly
*
$
D&B Authorization Form
*
Drop a file here or click to upload
Choose File
Maximum file size: 1MB
Certification of Vestry Meeting, including vote to approve spending plan request exceeding 5% annually.
*
Drop a file here or click to upload
Choose File
Maximum file size: 1MB
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