ESTATE PLANNING CLIENT INTAKE FORM

Estate Planning Intake Form

For Individual Estate Planning Documents - If married, each spouse should complete a separate form.
(1) CLIENT's Information: This is the Estate Plan of: (Please complete in full) This person is the "CLIENT"*
CLIENT's Birth Date

MonthDayYear
CLIENT's Marital Status*

Single/Never MarriedCurrently Married / Domestic PartnershipDivorcedWidowed
Does the CLIENT signing these documents have any children? (biological, adopted, estranged, stepchildren, pre-deceased)*

Yes - The document signer has childrenNo - The document signer does not have any children.
Health Care Power of Attorney

Name someone you trust to speak to your doctor if you are unable to speak for yourself. If you are able to communicate, your doctor will always follow your directions first. This document is only used if a dispute arises among others as to your treatment while unconscious.
Name of Client's FIRST Choice for HEALTH CARE Power of Attorney (only one name required)*

First NameLast Name
Name of Client's SECOND Choice for HEALTH CARE Power of Attorney

First NameLast Name
Financial Power of Attorney

Name someone you trust to handle your money and pay for your care. You only need one, a second name is listed to step in if the first person is unable to act.
Name of FIRST Choice for FINANCIAL Power of Attorney

First NameLast Name
Name of SECOND Choice for FINANCIAL Power of Attorney

First NameLast Name
Final Disposition Instructions

Directions on Disposition of Remains/funeral preferences (cremation, joint burial plot, ashes scattered etc. Include any religious services, locations, pre-paid arrangements, or specific actions requested. Any type of funeral service or preferences are welcomed. Be as detailed or brief as you prefer.
Final Disposition - You can be as detailed or as limited in details as you wish.
CLIENT'S PERSONAL PROPERTY: Any specific bequests that are individual, such as a specific item of jewelry, an identified vehicle, or other identifiable asset. This would be separate property - items owned just by one person, the CLIENT. Examples include the person's wedding ring, their military medals, cars, etc. When do these gifts get distributed, either at the time of Client's passing or at the Surviving Spouse's death?
Document WHAT is given to WHOM and WHEN - Be specific!
Naming the Executor of your Will, and Successor Trustee of your Trust

A Will has a named Executor, someone who has the job of following your directions and distributing your property. A Trust has a Successor Trustee (usually the other Spouse, or other Relative). In a Revocable Trust, the same person is both an Executor and Successor Trustee.
First Choice for Executor and/or Successor Trustee (can be Surviving Spouse)

First NameLast Name
Second Choice for Executor and/or Successor Trustee

First NameLast Name
Third Choice for Executor and/or Successor Trustee

First NameLast Name
Additional Information - Upload any documents or information that you want to include.

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Name of Person Completing this Form

First NameLast Name
Signature of Submitter - By signing below, I hereby affirm this information and request for document preparation is executed in good faith and with the full knowledge, consent and approval of the subject(s) of the estate plan.

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Should be Empty:

Estate Planning Intake Form

Health Care Power of Attorney

Financial Power of Attorney

Final Disposition Instructions

Naming the Executor of your Will, and Successor Trustee of your Trust