• Estate Plan Client Questionnaire

  • PERSONAL INFORMATION

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  • MARITAL INFORMATION
  • FAMILY INFORMATION
  • Child One

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  • Child Two

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  • Child Three

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  • If you now support your parents or other relatives, or wish to make provisions for them in your estate plan, please provide the following:

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  • Provide the following information as to those professionals (if applicable) who advise you.

  • Accountant:

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  • Investment Counselor/Financial Planner:

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  • Insurance Representative

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  • DISTRIBUTION AND PLAN OBJECTIVES
  • If you have minor children, provide the following information as to your first and second choice as guardian:

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  • Person 1 - who do you wish to serve as your Executor?

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  • Person 2 - who do you wish to serve as your Executor?

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  • Person 1 - who do you wish to serve as your Alternate Executor?

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  • Person 2 - who do you wish to serve as your Alternate Executor?

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  • Person 1 - who do you wish to serve as your Health Care Power of Attorney?

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  • Person 2 - who do you wish to serve as your Health Care Power of Attorney?

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  • Person 1 - who do you wish to serve as your Alternate Health Care Power of Attorney?

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  • Person 2 - who do you wish to serve as your Alternate Health Care Power of Attorney?

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  • Person 1 - if recommended, please list the Successor Trustee of your Revocable Living Trust?

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  • Person 1 - who is your primary Durable Power of Attorney in the event you cannot act for yourself.

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  • Person 2 - who is your primary Durable Power of Attorney in the event you cannot act for yourself.

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  • Person 1 - who is your alternate Durable Power of Attorney in the event your primary agent cannot act.

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  • Person 2 - who is your alternate Durable Power of Attorney in the event your primary agent cannot act.

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  • Should be Empty: