PERSONAL INFORMATION FORM

Completing this form prior to your meeting with an attorney will help us better prepare for the meeting and ensure that we have the necessary background to provide you with personalized legal advice. This form is designed to collect key information about you, your family, your assets and liabilities, and any specific concerns you may have regarding your estate planning or elder law matters. By filling it out in advance, we can spend more time during the meeting answering your questions and developing solutions tailored to your needs.

Once received, the information you provide will remain confidential and protected by attorney-client privilege, ensuring your privacy and security throughout the process.

In this section, please answer a few questions about yourself, including your full legal name (as it appears on your government-issued documents), date of birth, address, and other relevant details. Please ensure the information is accurate.

Provide your spouse's full legal name (as it appears on government-issued documents), date of birth, and other relevant details. Please ensure the information is accurate.

In this section, we ask you to answer a few questions about your existing estate plan, if you have one. Please indicate which of the following documents you have and how recent they are. For your long-term care insurance, if any, please specify the benefit and term of the policy. Complete this to the best of your knowledge.

Your health status is an important factor in creating an estate plan that best suits you and your loved ones. Please share any health issues or concerns you would like the attorney to be aware of as we prepare for your meeting.

In this section, please provide information about your children. Understanding your family dynamics is essential for creating an effective estate plan. The right plan can help address concerns, such as protecting your children's or grandchildren's inheritance from issues caused by their young age, marital problems, disability or special needs, lack of financial responsibility, and more.

In the following sections, you'll be asked to share some information about your income, assets, and liabilities. There is no need to provide exact numbers—an estimated value or ballpark figure will suffice. However, in order to properly counsel you on your estate planning matters, it is important for the attorney to understand how your estate is allocated among different types of assets (home and other real estate, retirement accounts, such as IRA, 401(k), 403(b), regular brokerage accounts, life insurance policies, annuities, etc.) Please complete this information to the best of your knowledge and comfort level.

Any information you provide to our office will be kept confidential and protected by attorney-client privilege.

In this section, we ask you to provide information about your monthly income. This information is important for estate planning because it helps us understand your financial resources and how they may affect your plan, including tax strategies, asset protection, and future inheritance planning. Additionally, knowing your income can be crucial when planning for long-term care, as it may influence your options for funding care and qualifying for benefits.

Please provide the following information regarding your assets, carefully placing values in each applicable category. Note that we distinguish between tax-deferred accounts, such as IRAs, 401(k), or 403(b) plans, and regular investment or brokerage accounts. This distinction is important due to the different tax treatments these assets receive. Please complete this section as accurately as possible.

Please provide the following information regarding your liabilities, including mortgages and other loans. Be sure to list the outstanding balances in each applicable category. Please complete this section as accurately as possible.

In this section, please provide information about any business interests you own. Whether you own the entire business or just a share, and whether it’s a small business or a larger enterprise, this information is crucial for estate planning. Many people tend to overlook the value of their business interests and fail to properly address them in their estate plan. Additionally, the type of business interest you own may have significant tax implications for your beneficiaries. That’s why we ask that you provide this information to the best of your knowledge, so the attorney can address it during your consultation, including any applicable asset protection options.

While the previous sections have covered a significant amount of information, there may still be other important considerations or concerns that you feel are necessary for the attorney to know as we prepare for your meeting. Estate planning is a comprehensive process, and any additional details about your situation could be critical to ensuring that your plan fully addresses your unique needs and circumstances.

In this section of the form, we ask you to share your goals and concerns related to your estate planning. We also ask that you rank how important different issues are to you. For example, avoiding probate, remaining in control, minimizing taxes, or protecting assets. This information is really important because it helps us understand what matters most to you. By knowing your priorities, we can tailor our advice to better meet your needs. Completing this section will make your meeting with the attorney much more productive, allowing us to focus on what’s most important to you and ensuring that we provide the best possible guidance for your situation.

You’re almost done! In the next (final) section of the form, we ask you several questions to help us understand which factors are most important to you. Everyone’s concerns are different, and estate planning is highly personal. You'll be asked to rank various issues related to estate planning, so we can better understand your priorities and what matters most to you.

On a scale from 'Not Important' to 'Critical,' please rank the importance of the following issues in your estate planning:

Once you have completed answering the questions, please click the 'Submit' button to securely transmit your responses to our office for the attorney's review.

We look forward to seeing you soon!