Estate Planning Form

We look forward to meeting with you soon to discuss your estate planning needs and goals. In order for us to best serve you, we would appreciate you taking a few minutes to complete the following information to the best of your ability. If some questions do not apply, or you have not had a chance to consider yet, please feel free to leave those sections blank.

All information provided will be held in strict confidence.

Have you done any estate planning in the past?

Your Full Legal Name

Your Address

Number and Street

City, State Zip

Your Cell Phone Number

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Your Email Address

Your Preferred Method of Communication From Our Office

Your Occupation

Your Annual Income

If Applicable:

Spouse's Full Legal Name

Spouse's Cell Phone Number

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Spouse's Email Address

Spouse's Occupation

Spouse's Annual Income

Children

Please provide information for all children in your family.

Child 1: Full Legal Name

Child 1: Birthdate

YYYY

Parents of Child 1

Child 2: Full Legal Name

Child 2: Birthdate

YYYY

Parents of Child 2

Child 3: Full Legal Name

Child 3: Birthdate

YYYY

Parents of Child 3

Children Information Cont.

Please include any other children you may have in the text box below.

Do any of your children have special needs?

Guardians for Minor Children

If any of your children are minors (under 18), who would you designate to serve as their guardian in the event it became necessary?

First Choice - Guardian

Second Choice - Guardian

Financial Designees

In the event of your incapacity or death, if your spouse is unavailable, who should be designated to handle your financial and property matters?

First Choice - Financial Designee (after spouse)

Second Choice - Financial Designee

Health Care Agents

In the event of your incapacity or death, if your spouse is unavailable, who should be designated to make medical decisions for you?

First Choice - Health Care Agent (after spouse)

Address

Phone

(###)

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Second Choice - Health Care Agent (after spouse)

Address

Phone

(###)

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Spouse's Health Care Agents

If your Spouse would like to designate the same agents you have listed, please skip this section.

Spouse's First Choice - Health Care Agent (after you)

Address

Phone

(###)

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Spouse's Second Choice - Health Care Agent (after you)

Address

Phone

(###)

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Asset Information

Please provide as much information as you can about your current asset ownership. All values can be ballpark estimates.

Real Estate

Please provide information for all real property owned, regardless of mortgage balance. For more than 2 properties, please list others in "Additional Information" section.

Address

Approximate Value

Type of Property

Primary Residence

Residential - rental or other

Farmground

Commercial

Vacant

Address

Approximate Value

Type of Property

Residential - rental or other

Farmground

Commercial

Vacant

Business Interests

Please list any interests you own in an LLC, Corporation or Partnership. For more than 1 business, please provide those entities in the "Additional Information" section.

Name of Entity

Financial Accounts

Please list all financial accounts (including banking, investments, retirement and life insurance). For more than 4 accounts, please provide those accounts in the "Additional Information" section.

Type of Account

Approximate Value

Type of Account

Approximate Value

Type of Account

Approximate Value

Type of Account

Approximate Value

Other Assets of Note

If you have other assets of value, please provide identifying information here.

Inheritance Expected

If you expect to receive an inheritance from anyone, please provide the relationship and approximate amount, if known.

ALMOST FINISHED!

Additional Information

Is there any additional information we should know about your family or your estate at this time? Please also use this section to provide any information that exceeded field capacities above.

How did you hear about our firm?

Please share how you found us or who referred you, thank you!

Click below to submit your information to our estate planning attorneys.