Estate Planning Questionnaire Part II

Estate Planning Questionnaire Part II

For the Spouse
The majority of the information in your trust is collected with the first form that you and your spouse should have filled out together.

This form is just for you to set forth your desires regarding provisions specific to you.
Email Address Used on Part I of the Form*
Please use the email address indicated in bold from the email you received linking you to this form
What name do you go by?*
E.g., Phil instead of Phillip or Susie instead of Susan
Street Address*

Street Address

Street Address Line 2

CityState

Zip Code
Home Phone*
Please enter a valid phone number.
Mobile Phone*
Please enter a valid phone number.

Powers of Attorney
The trust will name someone to make decisions on your behalf should you become unable to do so. This includes the General Power of Attorney, which is the ability to make business and financial decisions on your behalf (e.g., run your business, make sales or purchases on your behalf) and the Healthcare Power of Attorney, which is the ability to make medical decisions on your behalf (e.g., whether to pull the plug or use experimental medication or treatments on you).

Typically (but not necessarily) your spouse will be your primary power of attorney, with an adult child, relative, friend, or corporate trustee as alternate. Regardless, it should be someone you trust.
Do you want your spouse to be your general power of attorney?*

YesNo
General Power of Attorney*
Provide the full name of the general power of attorney, e.g., instead of "Stan Smith," put "Stanley G. Smith."
General Power of Attorney Address*
Provide the complete address of the general power of attorney, including street address, city, state, and zip code.
General Power of Attorney Email*
example@example.com
General Power of Attorney Phone Number*
Please enter a valid phone number.
Who would you like to appoint as your healthcare power of attorney?*

My spouseNot my spouse, but the same person as my general power of attorneySomeone else
Healthcare Power of Attorney*
Provide the full name of the general power of attorney, e.g., instead of "Stan Smith," put "Stanley G. Smith."
Healthcare Power of Attorney Address*
Provide the complete address of the general power of attorney, including street address, city, state, and zip code.
Healthcare Power of Attorney Email*
example@example.com
Healthcare Power of Attorney Phone Number*
Please enter a valid phone number.
Alternate Powers of Attorney

In the event your first choice cannot (or will not) act as power of attorney, the trust will designate an alternate. This should be someone you trust and cannot be the same person you designated as your power of attorney above.
Alternate General Power of Attorney
Alternate General Power of Attorney*
Provide the full name of the general power of attorney, e.g., instead of "Stan Smith," put "Stanley G. Smith."
Alternate General Power of Attorney Address*
Provide the complete address of the general power of attorney, including street address, city, state, and zip code.
Alternate General Power of Attorney Email*
example@example.com
Alternate General Power of Attorney Phone Number*
Please enter a valid phone number.
Alternate Healthcare Power of Attorney
Who would you like to appoint as your alternate healthcare power of attorney*

Same person as my alternate general power of attorneySomeone else
Alternate Healthcare Power of Attorney*
Provide the full name of the general power of attorney, e.g., instead of "Stan Smith," put "Stanley G. Smith."
Alternate Healthcare Power of Attorney Address*
Provide the complete address of the general power of attorney, including street address, city, state, and zip code.
Alternate Healthcare Power of Attorney Email*
example@example.com
Alternate Healthcare Power of Attorney Phone Number*
Please enter a valid phone number.

Provisions Related to Your Body
Do you want your trustee to have the power to donate your organs after death?*

YesNo
Burial Instructions*
How do you want your remains to be disposed of? Buried in a particular cemetery? Cremated and ashes kept in an urn ? (Note that if you want something other than burial in a cemetery or cremation, there may be legal limits that prevent your wishes from being carried out.) Provide instructions here in as much detail as you believe will be necessary to carry out your wishes.
Life-Saving Measures

Prolonging your life by artificial means.
Do you want your life to be artificially prolonged if you suffer from an incurable and terminal condition, or if you are in an irreversible coma?*

YesNo

Guardianship

If you become physically or mentally incapacitated such that a guardian needs to be appointed over you, you can elect whom you would like to be appointed.
If you need a guardian appointed over you if your physical or mental condition requires one, who would you like that to be?*

My spouseNot my spouse, but the same person I appointed as my general power of attorneySomeone else
Guardian Full Name*
Guardian Full Address*
Guardian Email*
example@example.com
Successor Guardian
Select a successor guardian in case your first choice for guardian is not available or willing to be appointed guardian over you.
Successor Guardian Full Name*
Successor Guardian Full Address*
Successor Guardian Email*
example@example.com
Before you submit the form, please review everything carefully for accuracy. If you have misspelled a name here, it will likely be misspelled in your trust (we hopefully will catch obvious errors, but we don't always know the correct spellings of proper nouns).
Estate Planning Questionnaire Spouse Submitted

YesNo
Should be Empty:

Estate Planning Questionnaire Part II

Powers of Attorney

Alternate Powers of Attorney

Alternate General Power of Attorney

Alternate Healthcare Power of Attorney

Provisions Related to Your Body

Life-Saving Measures

Guardianship

Successor Guardian