Trust and Estate Planning Input

| 220 Valley Rd Merion Station PA 19066 | 610.247.3520 | J2contracts@j2enterprises.net
J2 Estate Planning Questions
1. Power of Attorney
1.1 What state will this Power of Attorney be originated in and recognized?
1.2. Who is the originating Principal (Grantor) of this Power of Attorney?
1.3. Principal / Grantor Address, Phone Number, Email:
1.4. Who are the Agent(s) / Attorney(s)-in-Fact
1.5 Agent(s) / Attorney(s)-in-Fact Address:
1.6. If multiple Attorney’s-in-Fact, should they agree on decisions or can they act independently?

Must AgreeAct Independently
1.7 Do you wish to grant your Agent(s) / Attorney(s)-in-Fact General Authority?

YesNo
1.8. If not General Authority, what restrictions do you wish to put on your Attorney-in-fact?
1.9. My Attorney-in-Fact can co-own assets with me.

YesNo
1.10. My Attorney-in-fact can benefit from control of my assets.

YesNo
1.11. My Attorney-in-fact can delegate any granted authority

YesNo
1.12. I nominate my Attorney-in-fact to act as guardian or conservator for me.

YesNo
1.13. My Attorney-in-fact is required to prepare financial statements.

YesNo
2. Health Care Directive
2.1. Who are you appointing as your Health Care Agent?
2.2. Select the level of care you prefer: (Select Only One Choice)

Artificial Life Support + Artificial Food and Water + Comfort CareArtificial Food and Water + Comfort CareComfort Care only
3. Revocable Trust and Pour Over Last Will
3.1. List Full Name, City, State for Successor Trustee(s) to manage Trust
3.2. Do you have a spouse?

YesNo
3.3. Will your spouse inherit all the assets in the trust?

YesNo
3.4. List Beneficiaries: Full Names, City, State
3.5. Do you want to name any alternate beneficiaries in case a beneficiary refuses the inheritance or passes away without an heir? ( Full Name, City State )
3.6. What assets do you plan to transfer into the Living Trust? ( Real Estate / Financials / Personal Property / Other ) ( Select Only One Choice)

Real Estate / Financials / Personal Property / OtherFinancials / Personal Property / OtherPersonal Property / OtherOther
3.7. How do you want to divide the assets between the beneficiaries?

EquallyPercentages
3.8. If Percentages, list name and percentage.
3.9. Do you want your funeral costs and other final expenses to be paid out of the Living Trust?

YesNo
Should be Empty:

| 220 Valley Rd Merion Station PA 19066 | 610.247.3520 | J2contracts@j2enterprises.net