Email
*
Client's Legal Name
*
Client's Date of birth
*
Is Client a U.S. Citizen?
*
Yes
No
Spouse's Legal Name
*
Spouse's Date of Birth
*
Is spouse a U.S. citizen?
*
Yes
No
Spouse's Email Address
*
Date of Marriage
*
Has client ever been married to someone else?
*
Yes
No
Has spouse ever been married to someone else?
*
Yes
No
Children's Information: for all children, please include full legal name, gender, date of birth, who is a parent of this child (client, spouse, or both), address, and phone number.
Do any members of your family have special physical or mental challenges?
*
Yes
No
Successor Trustees: Who do you want to select as successor trustees? If neither of you are able to manage the trust, these people will manage your estate according to the instructions outlined in the trust. Please include a full legal name, gender, address, and phone number for EACH of your choices in order from first to third.
For client: Who do you want in control of financial decisions? Typically, your spouse will be the first choice, followed by second and third choices. Please include a full legal name, gender, address, and phone number for EACH of your choices in order from first to third.
For spouse: Who do you want in control of financial decisions? Typically, your spouse will be the first choice, followed by second and third choices. Please include a full legal name, gender, address, and phone number for EACH of your choices in order from first to third.
Proposed Guardian of any minor children: Please include full legal name, gender, address, and phone number for EACH of your three choices in order.
For client: patient advocate for patient advocate designation. This is someone you would want in control of medical decisions. Typically, your spouse will be the first choice, followed by second and third choices. Please include full legal name, gender, address, and phone number for EACH of your three choices in order.
For client: Do you want to provide that your patient advocate have authority to end life support if there is no hope of recovery?
*
Yes
No
For client: Do you want to provide that your organs and tissues be made available for transplant and/or research purposes?
Niether
Transplant only
Research only
Both
For client: Do you prefer your remains be cremated or buried?
*
Cremated
Buried
For spouse: patient advocate for patient advocate designation. This is someone you would want in control of medical decisions. Typically, your spouse will be the first choice, followed by second and third choices. Please include full legal name, gender, address, and phone number for EACH of your three choices in order.
For spouse: Do you want to provide that your patient advocate have authority to end life support if there is no hope of recovery?
Yes
No
For spouse: Do you want to provide that your organs and tissues be made available for transplant and/or research purposes?
Neither
Transplant only
Research only
Both
For spouse: Do you prefer your remains be cremated or buried?
Cremated
Buried
What is your monthly income?
What is your spouse’s monthly income?
How much is all of your real estate worth?
How much is the balance of all of your mortgages?
How much money do you have in previous employer’s 401k, 403b, and 457 accounts?
How much money does your spouse have in previous employer’s 401k, 403b, and 457 accounts?
How much money does your spouse have in current employer’s 401k, 403b, and 457 accounts?
How much money do you have in current employer’s 401k, 403b, and 457 accounts?
What is the death benefit of your life insurance?
What is the death benefit of your spouse’s life insurance?
What is the cash value of your life insurance? (only for whole or universal life insurance)
What is the cash value of your spouse’s life insurance? (only for whole or universal life insurance)
What is your net worth?
Do you have long-term care insurance?
Does your spouse have long-term care insurance?
What is your address?
Please list the full legal name, gender, address, and phone number (if available) of those who are to be the primary beneficiaries of your estate. (i.e. spouse first, children second, etc. and ages you would like minors to receive any distribution and the amount of that distribution by percentage). For example, all children receive 10% at age 21, 50% at age 30, and 40% at age 35.
Please provide full legal name, gender, address, and phone number of those to whom you would leave your estate (final takers) and the percentages for each in case all of your primary beneficiaries predecease you or perish with you.
If you wish to make any charitable or other special gifts, please indicate the charity and the amount you wish to donate.
Do either the client or the spouse have a safety deposit box? If so, where is each safety deposit box located?
Present documents: please list wills (and dates), Trusts created by the client/spouse (and dates, Trusts created for the client/spouse (and dates), and gift tax returns (and dates). Copies may be uploaded to the portal for review.
Advisors (names and addresses): Accountant, Trust Officer, Commercial Banker, Investment Advisor, Stockbroker, Life Insurance Agent, and Casualty Insurance Agent
If a business is owned, please indicate name of business, address of business, and ownership percentage of each party. Copies of business documents such as operating agreements may be uploaded to the portal for review.
Submit