Estate Planning Questionnaire

Please fill out this form to the best of your abilities. This will aid us in preparing your estate planning.

Full Legal Name *
Full Legal Name
Spouse's Legal Name *
Spouse's Legal Name
Home Address *
Home Address
Home Phone *
Home Phone
Mobile Phone
Mobile Phone
Advisors
Name + Phone
Name + Phone
Children
Child of:
Child's Name
Child's Name
Child's Address
Child's Address
Child's Phone
Child's Phone
Child of:
Child's Name
Child's Name
Child's Address
Child's Address
Child's Phone
Child's Phone
Husband
In the event you are unable to handle your affairs with respect to your property, bank accounts, etc., who would you like to appoint as your attorney-in-fact if your SPOUSE is unable to act? Your attorney-in-fact is authorized to continue to act while you are incapacitated.
Name
Name
Address
Address
Phone
Phone
Husband
In the event you are unable to make medical decisions for yourself, who would you like to appoint as your health care surrogate if your SPOUSE is unable to act?
Name
Name
Address
Address
Phone
Phone
Wife
In the event you are unable to handle your affairs with respect to your property, bank accounts, etc., who would you like to appoint as your attorney-in-fact if your SPOUSE is unable to act? Your attorney-in-fact is authorized to continue to act while you are incapacitated.
Name
Name
Address
Address
Phone
Phone
Wife
In the event you are unable to make medical decisions for yourself, who would you like to appoint as your health care surrogate if your SPOUSE is unable to act?
Name
Name
Address
Address
Phone
Phone
Administration
Who will administer your estate upon your death if your SPOUSE is unable to act?
Name
Name
Address
Address
Phone
Phone
Alternate
Name
Name
Address
Address
Phone
Phone