Estate Planning

MARITAL INFORMATION
Date of Marriage

Month Day Year
Prenuptial Agreement?

Yes No
Prior Marriage?

Yes No
His/her Deceased Spouse(s) and Date of Death
His/her Divorced Spouse(s) and Date of Divorce

DISTRIBUTION AND PLAN OBJECTIVES
Who would you like your assets distributed to at your passing and in what percentages? Do not be concerned with the "legalisms", just explain how you wish the assets to be distributed and who or what charities/entities should receive the assets.
If you have minor children, provide the following information as to your first and second choice as guardian:
Full Name

Prefix First Name Middle Name Last Name Suffix
Phone Number

Area Code Phone Number
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Person 1 - who do you wish to serve as your Executor?
Relationship
Full Name

Prefix First Name Middle Name Last Name Suffix
Phone Number

Area Code Phone Number
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Person 2 - who do you wish to serve as your Executor?
Relationship
Full Name

Prefix First Name Middle Name Last Name Suffix
Phone Number

Area Code Phone Number
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Person 1 - who do you wish to serve as your Alternate Executor?
Relationship
Full Name

Prefix First Name Middle Name Last Name Suffix
Phone Number

Area Code Phone Number
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Person 2 - who do you wish to serve as your Alternate Executor?
Relationship
Full Name

Prefix First Name Middle Name Last Name Suffix
Phone Number

Area Code Phone Number
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Person 1 - who do you wish to serve as your Health Care Power of Attorney?
Relationship
Full Name

Prefix First Name Middle Name Last Name Suffix
Phone Number

Area Code Phone Number
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Person 2 - who do you wish to serve as your Health Care Power of Attorney?
Relationship
Full Name

Prefix First Name Middle Name Last Name Suffix
Phone Number

Area Code Phone Number
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Person 1 - who do you wish to serve as your Alternate Health Care Power of Attorney?
Relationship
Full Name

Prefix First Name Middle Name Last Name Suffix
Phone Number

Area Code Phone Number
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Person 2 - who do you wish to serve as your Alternate Health Care Power of Attorney?
Relationship
Full Name

Prefix First Name Middle Name Last Name Suffix
Phone Number

Area Code Phone Number
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Person 1 - if recommended, please list the Successor Trustee of your Revocable Living Trust?
Relationship
Full Name

Prefix First Name Middle Name Last Name Suffix
Phone Number

Area Code Phone Number
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Person 1 - who is your primary Durable Power of Attorney in the event you cannot act for yourself.
Relationship
Full Name

Prefix First Name Middle Name Last Name Suffix
Phone Number

Area Code Phone Number
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Person 2 - who is your primary Durable Power of Attorney in the event you cannot act for yourself.
Relationship
Full Name

Prefix First Name Middle Name Last Name Suffix
Phone Number

Area Code Phone Number
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Person 1 - who is your alternate Durable Power of Attorney in the event your primary agent cannot act.
Relationship
Full Name

Prefix First Name Middle Name Suffix
Phone Number

Area Code Phone Number
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Person 2 - who is your alternate Durable Power of Attorney in the event your primary agent cannot act.
Relationship
Full Name

Prefix First Name Middle Name Suffix
Phone Number

Area Code Phone Number
Last Name

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Person 1 - do you wish to be cremated or buried? *
Person 2 - do you wish to be cremated or buried?
Person 1 - do you have pets? If so, who is your Pet Care Agent?
Person 2 - do you have pets? If so, who is your Pet Care Agent?
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