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Standalone Legal Document Request to Berg Bryant
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1
Stand Alone Document Creation Interview Form
This form is appropriate if you are looking for a Will, Durable Power of Attorney, or both. You will want to schedule a Free Intake Call with our team if you desire additional legal documents as our plan pricing will offer the better deal for you.
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2
Document Selection and Signor Overview
Please watch this short video to make sure that you are in the right place!
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3
Select the documents you are looking to purchase?
*
This field is required.
Note: Additional documents not appearing on this form will require a different form for completion and a free phone intake call with one of our trained team members. A la carte pricing is a higher fee per document and there are discounts from our a la carte fees in our package plans.
1 Simple Will
2 Simple Wills (husband and wife)
1 Durable Power of Attorney
2 DPOAs (for H&W)
None of these
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4
Who will be signing the documents?
*
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You
You and your spouse
Someone else
Someone else and their spouse
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5
Is the person signing the legal documents able to travel and attend an appointment at one of our office locations?
*
This field is required.
Offices are located in Jacksonville (Deerwood Area off Southside/JTB) and Orange Park (Office located near Park/Kingsley across from Winn Dixie)
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NO
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6
If you are driving the person who will sign the documents at the office and you are not this signor's spouse, would you be willing to wait in the lobby while we review and execute the documents with the person you bring to the appointment?
*
This field is required.
NOTE: We recommend that if you are completing this form for someone else that you remove yourself far from the process due to potential claims that invalidate the documents or lead to elder financial exploitation claims. Removing yourself means not paying legal fees, not driving to the appointment, and not being present during the review and signing meeting.
YES
NO
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7
Does the person(s) signing the legal documents have excellent mental capacity?
*
This field is required.
Excellent mental capacity means that the person is alert and conversational. The person knows all important data points about themselves such as name, family names and relationship, and personal vital statistics. The person is aware of the year and current events. The person knows their address and location. The person can make decisions on a day to day basis.
YES
NO
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8
Legal Fee and Scope of Representation Overview
Please watch this short video about our fees and what our firm will do to earn the legal fee.
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9
Legal Fees: A Simple Last Will and Durable Power of Attorney are $500 for each document for the first signor, and $250 for each document for the spouse, with an in-office signing with an attorney that is 30 minutes or less. Do you understand and agree to the legal fees?
*
This field is required.
By answering "Yes" you will not be charged. We will send you a separate fee agreement and link for online payment after reviewing this completed form.
YES
NO
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10
Travel Signing Fees: Do you or the person signing the legal documents agree to pay for the attorney's time for travel to and from the signing location and the mobile notary fee?
*
This field is required.
Fees are calculated based on the distance from our closest office to the signing location.
YES
NO
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11
Process Overview
1) Answer the remaining questions in this interview; 2) Sign the Fee Agreement and Pay the Retainer we will send you; 3) We will call to confirm the information and setup a signing
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12
What is your name?
*
This field is required.
Please enter your name how it appears on your valid photo ID such as a Driver's License, Military ID, or state issued ID. Be prepared to send the Photo ID prior to the appointment.
Mr.
Ms.
Dr.
Mr.
Mr.
Ms.
Dr.
Prefix
First Name
Middle Name
Last Name
Suffix
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13
What is the name of the person who will sign the legal document?
*
This field is required.
Please enter the name how it appears on your valid photo ID such as a Driver's License, Military ID, or state issued ID. Be prepared to send the Photo ID prior to the appointment.
Mr.
Ms.
Dr.
Mr.
Mr.
Ms.
Dr.
Prefix
First Name
Middle Name
Last Name
Suffix
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14
What is the name of the spouse, who would be the second person to sign legal documents?
*
This field is required.
Please enter the name how it appears on your valid photo ID such as a Driver's License, Military ID, or state issued ID. Be prepared to send the Photo ID prior to the appointment.
Mr.
Ms.
Dr.
Mr.
Mr.
Ms.
Dr.
Prefix
First Name
Middle Name
Last Name
Suffix
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15
Durable Power of Attorney Overview and Decisions
Watch this for quick, basic directions about this form and your options.
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16
Do both signors agree to name the same people (including each other in the respective documents) under the Durable Power of Attorney?
*
This field is required.
YES
NO
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17
What is the name of the person that will be named as Agent under the Durable Financial Power of Attorney?
*
This field is required.
This person should be trustworthy, ethical, and can complete a task. This person does not necessarily have to live close to you.
Prefix
First Name
Middle Name
Last Name
Suffix
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18
We recommend naming an alternate Agent should the primary named Agent become unwilling or unable to serve. Is there a person who can be named as a successor?
*
This field is required.
Note: if "No" is answered, we will not ask for the second signor's preferred name in this interview. In some cases, this discrepancy causes us to be unable to complete the work at the standalone document rate quoted above.
YES
NO
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19
What is the name of the backup person who you want to name as Successor Agent under your Durable Financial Power of Attorney?
*
This field is required.
This person should be trustworthy, ethical, and can complete a task. This person does not necessarily have to live close to you.
Prefix
First Name
Middle Name
Last Name
Suffix
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20
Last Will and Testament Overview and Decisions
Watch this for quick, basic directions about this form and your options.
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21
Do both signors agree to name the same people (including each other in the respective documents) as Executor (or Personal Representative) under the Last Will and Testament?
*
This field is required.
YES
NO
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22
What is the name of the person who you want to name as Executor (we call the job Personal Representative) under the Last Will and Testament?
*
This field is required.
This person should be trustworthy, ethical, and can complete a task. This person does not necessarily have to live close to you.
Prefix
First Name
Middle Name
Last Name
Suffix
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23
We recommend naming an alternate Personal Representative should your primary named Personal Representative become unwilling or unable to serve. Is there a person who can be named as successor Personal Representative?
*
This field is required.
YES
NO
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24
What is the name of the person to serve as alternate Executor/Personal Representative under the Last Will and Testament?
*
This field is required.
This person should be trustworthy, ethical, and can complete a task. This person does not necessarily have to live close to you.
Prefix
First Name
Middle Name
Last Name
Suffix
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25
2nd Signor: Does the spouse who will also be signing agree to the same Personal Representative and Successor?
*
This field is required.
YES
NO
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26
What would you like said in your last will and testament about the disposition of your remains?
*
This field is required.
Cremated; ashes scattered
Cremated, executor may decide
Cremated; ashes buried
Embalmed and buried
Nothing; do not include in my will
We can fill it in when I sign
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27
Which option best describes how you want to leave all your assets after you pass away?
*
This field is required.
100% to my Spouse; if predeceased, then to my children who survive me, equally (and not their children)
100% to my Spouse; if predeceased, then to my children who survive me, and to their children if a child predeceases me
To my children who survive me, equally (and not your grandchildren)
To my children who survive me, equally, and to their children if a child predeceases me
Equally to the survivors of the people or charities I name in the next question
None of these; I'll explain in the next answer prompt
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28
How would like all your assets distributed? Provide the full name for each person you want named in your documents.
*
This field is required.
NOTE: If you find yourself naming more than 4 people who are not your children or 4 different instructions about particular assets, then you have exceeded our definition of a "simple will" we cannot provide you a standalone last will and testament.
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29
What is your email address?
*
This field is required.
example@example.com
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30
What is your phone number?
*
This field is required.
Please enter a valid phone number.
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31
What is the address of the person who is signing documents?
*
This field is required.
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
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32
Please schedule a Free Intake Call to discuss your situation and this form by selecting a date and time below:
Choose a time on the calendar below. After booking your time, you will be sent another form for completion. Please complete the form prior to your scheduled call.
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33
Do you have anything else you want to share with us?
We will call you to go over these answers, confirm that we are moving forward, collect payment, and set a signing meeting.
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