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Intake Form

Thank you for your interest in creating a new CLAT.  This Intake Form is used to gather all the relevant information that is necessary to start your new iCLAT engagement.  All of the information that you provide to us on this Intake Form will be kept private and confidential at all times.  We will not disclose any of your information to any third parties (such as your accountant, financial planner and/or attorney) unless you give us the express consent to do so (on this form or otherwise).  Note, this digital Intake Form is the preferred method by which we gather the necessary information to start working on your iCLAT.  However, if you prefer to provide this information to us by mail, fax or email, then click HERE to download a PDF Version of this Intake Form. 

4. What is your estimated income ("AGI") for the current tax year (or next year, if applicable based on your applicable facts)? Note, the answer to this question is important because the iCLAT generates the largest amount of "accelerated" income tax savings in a year that you have a high level of income.
5. How common is the level of income ("AGI") that you selected above in Question #4 for you?
6. Please indicate whether the MAJORITY of the income described in Question #4 is attributable to any of the following types of "ORDINARY INCOME" (select all that are applicable).
7. Do you expect any of following events to occur for you in the NEXT THREE YEARS (If more than one event is applicable, then select the event that you think is most likely.):
8. Do you reside in any of the following States, which have BOTH a separate state income tax AND some form of charitable deduction at the state level? (AL, AZ, AR, CA, CO, DE, DC, GA, HA, ID, IA, KS, KY, LA, ME, MD, MN, MI, MO, MT, NE, NM, NY, NC, ND, OK, OR, RI, SC, UT, VT, VA or WI)
9. Select your preferred class of assets to fund you iCLAT.
10. How old are you?
11. Have you ever established any of the following charitable planning tools?
14. If referred by an advisor, would you like your responses from us sent to them also?

iCLAT® is a registered trademark of Effectual Giving, LLC and used on this website by iCLAT Solutions, LLC an authorized licensee of Effectual Giving, LLC.  

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