• ESTATE PLANNING CLIENT INTAKE FORM

  • Please complete this Estate Planning Client Intake Form to the best of your knowledge. I ask that you provide as much detail as possible so that I can accurately evaluate your situation and properly advise you regarding your estate planning options. All information provided with this Intake Form will be held in strict confidence.

  • When filling out this Intake Form please use full legal names and make sure that the names of any party listed are spelled correctly. If more space is needed, please feel free to attach additional pages as necessary. If you are unsure about how to answer some of the questions, simply indicate on the form that you would like to discuss the subject matter at our initial consultation.

  • Please complete and return this form to me via email or mail at least 24 hours prior to our initial consultation. I look forward to working with you.

  • CLIENT INFORMATION:

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  • CHILDREN:

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  • OTHER DEPENDENTS:

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  • ADDITIONAL CLIENT INFORMATION:

  • PLANNING CONSIDERATIONS:

    Personal Representative: The person who will administer your estate in probate after you die.
  • Personal Representative: The person who will administer your estate in probate after you die.

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  • Danielle M. Shyne, Shyne Law Group, Estate Planning Intake Form
  • Successor Trustee:

    The person who will manage your trust if you become incapacitated or administer your trust after you die.
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  • Durable Financial Power of Attorney:

    The person who can make financial, legal, and property decisions on your behalf if you become incapacitated.
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  • Durable Healthcare Power of Attorney:

    The person who can make healthcare decisions on your behalf if you become incapacitated.
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  • Guardians for Minor Children:

    The person(s) responsible for raising your minor children in the event that you and your spouse die.
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  • Conservators for Minor Children:

    The person(s) responsible for managing the financial and legal affairs of your minor children in the event that you and your spouse die.
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  • Danielle M. Shyne, Shyne Law Group, Estate Planning Intake Form
  • Caretakers for Pets and Livestock:

    The person(s) you would want to take care of your pets or other animals in the event that you and your spouse die
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  • PLANNING GOALS:

    Please check which of the following issues are important to you:
  • Danielle M. Shyne, Shyne Law Group, Estate Planning Intake Form
  • ASSET/LIABILITY SUMMARY

    (Please list values in U.S. dollars):
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  • Danielle M. Shyne, Shyne Law Group, Estate Planning Intake Form
  • DETAILED ASSET/LIABILITY INFORMATION:

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  • BANK AND INVESTMENT ACCOUNTS

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  • PARTNERSHIP, LLC, CORPORATION OR SOLE PROPRIETOR INTERESTS

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  • Danielle M. Shyne, Shyne Law Group, Estate Planning Intake Form
  • LIFE INSURANCE, PENSION, IRAs, 401(k)

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  • VALUABLE PERSONABLE PROPERTY:

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  • Danielle M. Shyne, Shyne Law Group, Estate Planning Intake Form
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  • Should be Empty: