Sample Beneficiary Designation

To designate the Los Angeles LGBT Center as a beneficiary of a qualified retirement plan, life insurance policy, or in some other way, please use the following information:

The Los Angeles LGBT Center, a Los Angeles, CA, nonprofit charitable organization, is presently located at Anita May Rosenstein Campus, 1118 N McCadden Place, Los Angeles, CA 90038.
Tax ID #: 95-3567895

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Primary Beneficiary Designation

Full name (Last, First, Middle Initial) Relationship SSN/TIN Address (Street, City, State, ZIP) Share %
Melanie, Smith, L Spouse 333-33-3333 123 Main St., Anytown, US 12345 60%
John, Doe, J. Brother 222-22-2222 456 Main St., Anytown, US 12345 20%
The Los Angeles LGBT Center Charity 95-3567895 1625 N. Schrader Boulevard, Los Angeles, CA 90028-6213 20%
TOTAL: 100%

For More Information

If you have any questions, please contact Nellie A. Sims, J.D., Director of Planned Giving, at 1-323-993-7606 or