Access To Justice Fund Contribution Form Legal Aid And Defender
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1Legal Aid and Defender Association Civil Law Group
Access to Justice Fund Contribution Form
(For Michigan Residents)
My gift of $
for Legal Aid and Defender
I wish to make my gift: □ in memory of □ in honor of
Association Civil Law Group is to support:
name of honoree/designee
□ Current Services
Please list name(s) and address(es) of person(s) to be notified
□ Endowment Fund
of your memorial or honorarium gift:
Bar P No.
Date
Name
Firm/Address
□ Please contact me with information regarding planned
giving to the Access to Justice Fund for LAD.
City
State
Zip
□ I have included a gift to the Access to Justice Fund for
LAD in my will or trust, estate plan, or retirement plan.
Phone
Email
ANNUAL GIFT RECOGNITION
$500,000 & up
Justice Society
My gift will be paid as follows:
$100,000–$499,999
Founder
□ Paid in full by check payable to the Access to Justice
$50,000–$ 99,999
Humanitarian
Fund (enclosed).
$25,000–$49,999
President
$10,000–$24,999
Steward
□ Pledged in _____ annual installments of $
,
$5,000–$9,999
Patron
invoiced to me by
of each year.
$2,500–$4,999
Benefactor
□ Please charge my credit card for:
$1,000–$2,499
Champion
□ the full amount of my gift
$500–$999
Pacesetter
□ my first pledge payment
$300–$499
Supporter
□ each pledge payment when due
$0–$299
Contributor
Credit Card Type: □Visa □MasterCard
Planned Gifts
Roberts P. Hudson
Card Number
Legacy Society
Expiration Date
□ Check here if you do NOT want your name(s) to be
Signature
published for reporting or donor recognition purposes.
□ With stocks, bonds, or mutual funds.
For more information about LAD, please visit our website at
(Please use the ATJ Fund stock transfer form located at
.
For year-end gifts, please submit that form to your broker and
the ATJ Fund by December 15.)
Please return this completed form (and check, if applicable) to:
Access to Justice Fund, Michigan State Bar Foundation, 306 Townsend Street, Lansing, MI 48933
Legal Aid and Defender Association Civil Law Group participates in the Access to Justice Campaign to increase resources for
civil legal aid to the poor in Michigan. The ATJ Campaign is a partnership of the State Bar of Michigan, the Michigan State Bar
Foundation and Michigan's civil legal aid programs. Tax deductible contributions to the ATJ Fund are received and administered
by the Michigan State Bar Foundation according to the Access to Justice Fund Guidelines located at
Revised October 2012
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