D. Parker Law Wills Intake Form
Name
*
First Name
Last Name
Marital Status
Married - living spouse
Widow/Widower
Divorced
Unmarried partner
Single
Date of Birth
Spouse's Name (if living)
First Name
Last Name
Spouse date of birth (if living)
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
-
Area Code
Phone Number
Spouse Phone Number
-
Area Code
Phone Number
Email
example@example.com
Spouse Email
example@example.com
I/we would like the following legal services:
A will for one person
Wills for a married couple
Wills for a non-married couple
An estate package add-on including a Power of Attorney and Living Will for one person (additional $50 charge)
An estate package add-on including a Power of Attorney and Living Will for two people (additional $100 charge)
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If you are married and were to die first, ordinarily all your property would pass to your spouse. Are these your wishes?
Yes
No
Not sure
Not married and so not applicable
Other than your spouse (or if you do not have a spouse or were to die after your spouse), list the names, ages, and addresses of heirs you wish to inherit under the will:
Do you have anything else regarding your heirs or the distribution of your property that you want your will to address?
Do you have any property worth more than $500 that you want to pass to a specific person? If so, list the property and the individual who should receive that.
Name of the person you wish to be the personal representative (executor) of the will
First Name
Last Name
Address of the person you wish to be the personal representative (executor) of the will
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Name and address of alternate personal representative(s), if any
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Do you have minor children under 18 years of age?
Yes
No
If you have Minor Children, name of the person you would like to recommend for guardianship of your children in the event that there is no living parent.
First Name
Last Name
If you have Minor Children, address of the person you would like to recommend for guardianship of your children in the event that there is no living parent
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Name and address of alternate guardian(s), if any
Have you already called D. Parker Law to schedule your Wills Consultation?
*
Yes
No
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