Estate Planning Intake Form: Individual

Estate Planning Intake Form

Please complete this intake form to help us prepare your estate planning documents. Fill out all applicable sections. If unsure, leave fields blank and we will follow up.
Which Estate Plan Package would you like to proceed with?*

Trust Package: Individual Custom TrustTrust Package: Individual TrustWill Package: Individual Custom WillWill Package: Individual Will

Client Information
What is your full legal name?*
What is your email?*
We will email you and/or call you to clarify any details.
What is your phone number?*
We will email you and/or call you to clarify any details.Format: (000) 000-0000.
In what county do you currently reside? (e.g. Ramsey, Hennepin, etc.)*
What is your current address?*
What is your date of birth?*

MonthDayYear
Do you own a business?*

YesNo

Personal Representative (Executor)

A Personal Representative is the person who will be responsible for collecting and inventorying your assets, paying debts, and distributing assets in accordance with your Will.
Primary Personal Representative: Full legal name & relationship*
Please enter the full legal name of the person you would like to nominate as your Personal Representative followed by their relation to you (e.g. spouse, sister, etc).
Successor Personal Representative: Full legal name & relationship
In the event your chosen Personal Representative is unable to serve, please enter the full legal name of the person you would like to name as your successor Personal Representative followed by their relationship with you (e.g. brother, friend)
Trustee

A Trustee is a person responsible for administering a trust. If you create a Living Trust, this person will act when you die or become incapacitated. If you create a Will but have beneficiaries who aren’t able to independently manage their inheritance yet, the Trustee can administer an inheritance for the beneficiary until they reach an age you select.
Primary Trustee: Full legal name & relationship*
In the event of your death, state the full legal name of the person you would like to nominate as your Trustee, followed by their relationship to you (e.g. friend, brother-in-law, etc.).
Successor Trustee: Full legal name & relationship
It is often helpful to list a successor Trustee in case your primary selection is unable to fulfill that role. Please enter the full name of the person you would like to name as successor Trustee followed by their relation to you (e.g. friend, brother, etc.).
At what age would you like minors to have full access to and control of their inheritance?
Our default age is 25. You may select a different age, provided it is at least 21.
Specific Gifts

Specific Gifts are gifts of specific items or amounts that would be made from your estate before the rest of the estate is distributed. List any specific gifts you’d like to make, including the recipient’s name and item or amount (e.g., $100.00 to Habitat for Humanity or my grandmother’s China set to my niece Jane Doe):
Recipient Legal Name e.g., Jane Lou Doe Relationship e.g., sister Item or Amount of Gift e.g., $500.00
Recipient Legal Name e.g., Jane Lou Doe Relationship e.g., sister Item or Amount of Gift e.g., $500.00
Recipient Legal Name e.g., Jane Lou Doe Relationship e.g., sister Item or Amount of Gift e.g., $500.00
Recipient Legal Name e.g., Jane Lou Doe Relationship e.g., sister Item or Amount of Gift e.g., $500.00
Remainder of Estate
After any specific gifts are made, how you would like the rest of your estate to be divided or distributed? (Examples could include “split equally among my sibilings;” “1/3 to John Doe, 1/3 to Jane Doe, and 1/3 to Susan Doe;” or other terms as you see fit.)
Our default distribution follows next of kin: first to your spouse, then your descendants, then your parents, then your siblings, and so on.
Notes, comments, or additional information

Power of Attorney
Attorney-in-Fact: Full legal name*
Attorney-in-Fact. This is the person you are authorizing to handle your finances if you are alive but unable to do so. This may be anyone over 18 who you trust to act on your behalf. (It does not have to be an attorney.)
Attorney-in-Fact: Address*
Successor Attorney-in-Fact: Full legal name
In the event your Attorney-in-Fact is unable or unwilling to serve, please enter the full legal name of the person you would like to nominate as the Successor Attorney-in-Fact.
Successor Attorney-in-Fact: Address

Health Care Directive
Health Care Agent: Full Legal Name & Relationship*
An Agent is the person who you want to make health care decisions for you if you cannot make them yourself. Please enter the following information for the person you would like to be your agent.
Health Care Agent: Address*
Health Care Agent: Phone Number*
Format: (000) 000-0000.
Successor Health Care Agent: Full Legal Name & Relationship
A Successor Agent is the person who would either take the Agent’s place if the Agent is unavailable or otherwise unable to perform their duties.
Successor Health Care Agent: Address
Successor Health Care Agent: Phone Number
Format: (000) 000-0000.
If you wish to appoint multiple Agents who have simultaneous authority to make health care decisions for you, must all Agents agree on any decision?*

All Agents must agreeEach Agent may act independentlyI am not appointing multiple Agents who have simultaneous authority
Can your Agent consent for you to receive intrusive mental health treatment, such as voluntary or involuntary administration of electroshock therapy and neuroleptic, psychotropic, or psychoactive medications?*

YesNo
Please indicate your preference if you become terminally ill and are unable to express your wishes.*

Use all medical treatment that is needed to keep me aliveKeep me comfortable and allow natural death to occur
Do you wish to donate your organs and tissue if you die?*

YesNo
Do you wish to be cremated, buried, or something else?*
Is there a place you wish to be buried or have your ashes spread/interred?
Other instructions

Individual Custom Trust

Individual Trust

Individual Custom Will

Individual Will

Should be Empty:

Estate Planning Intake Form

Client Information

Personal Representative (Executor)

Trustee

Specific Gifts

Remainder of Estate

Power of Attorney

Health Care Directive

Individual Custom Trust

Individual Trust

Individual Custom Will

Individual Will