Make your reservation.

(This offer is for N.C. residents only)

Please complete the information below. Once we receive your information, one of our staff members will contact you to reserve a time.

You will then meet with the attorney at the scheduled time on November 5th to discuss your specific wishes. At that time, the documents will be produced, fully executed, and ready to take home that same day.

If you need assistance at any time, please contact us at 919-844-7993.

You are completing this form as: *

Individual Married Couple

Client One Full Name *

First Name Middle Name Last Name

Are You a US Citizen? *

Yes No

If No, Please List Status

Married? *

Yes No

Gender *

Male Female

Date of Birth *

Month Day Year

Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country

County of Residence *

Preferred Phone Number *

Area Code Phone Number

Preferred E-mail Address *

Client Two Full Name (If you are participating with a spouse)

First Name Middle Name Last Name

Are You a US Citizen?

Yes No

If No, please list status

Gender

Male Female

Date of Birth

Month Day Year

Preferred Phone Number

Area Code Phone Number

Preferred E-mail

Children - Please list all children that you have. *

How many children do you have? *

Child 1's Full Name

First Name Middle Name Last Name

Child 1's Date of Birth

Month Day Year

Child 2's Full Name

First Name Middle Name Last Name

Child 2's Date of Birth

Month Day Year

Child 3's Full Name

First Name Middle Name Last Name

Child 3's Date of Birth

Month Day Year

Child 4's Full Name

First Name Middle Name Last Name

Child 4's Date of Birth

Month Day Year

Child 5's Full Name

First Name Middle Name Last Name

Child 5's Date of Birth

Month Day Year

Child 6's Full Name

First Name Middle Name Last Name

Child 6's Date of Birth

Month Day Year

Are any of the children listed above deceased? If so, please list below along with any descendants that child may have.

Retainer Agreement

You have requested that The Law Offices of Jeffrey G. Marsocci, PLLC (“The Firm”) act as your legal counsel with regard to the preparation of estate planning document(s) for you. We have discussed with you the terms and conditions under which we have agreed to represent you and under the terms and conditions of that Agreement, we will prepare the appropriate documents consistent with your stated wishes and goals. This letter will serve to confirm our Agreement.

By signing this Agreement, you agree that you are acting with a clear conscience and state of mind, you understand and agree to the terms of this Agreement, you have provided the attorney and firm with all relevant information related to the preparation of planning your estate, and that you will convey to the attorney or firm any and all relevant information in the future. You understand and agree to waive any right to file any dispute and claim against The Law Offices of Jeffrey G. Marsocci, PLLC or its successors in interest for your failure to read and understand the full terms of this Agreement, and the estate planning documents this representation is based on. The waiver shall extend to any and all information – whether you consider the information crucial or not – that was not conveyed to the attorney and/or the firm before, during, and after the signing of this Agreement and/or your estate planning document(s).

The various Plans offered has been listed below for your review and shall serve as a point of reference for services rendered. The plan chosen is checked and any adjustments are written in the notes section.

Plan Options

Simple Will Plan - Last Will & Testament Only

Simple Will Package - Last Will & Testament, Durable Power of Attorney, Healthcare Power of Attorney, Nomination of Conservator, and Living Will

Please select Your Plan - Price is per person

Simple Will Plan $149 Simple Will Plan 499 - Age 65+ Simple Will Package $249 Simple Will Package $199 - Age 65+

I/we specifically bind ourselves, our heirs, agents, assigns and representatives of any kind from taking action against The Law Offices of Jeffrey G. Marsocci, PLLC or its successors in interest from any and all added costs or problems that may result from having only a Last Will and Testament prepared by our firm as opposed to the full simple will package and/or a revocable living trust package.

In consideration for this work, you agree to pay our firm the amount or amounts stated above. This amount applies only to The Simple Will Clinic and is non-transferrable to any other plans offered by The Law Offices of Jeffrey G. Marsocci, PLLC or its successors in interest, which may require a regular estate planning process. FURTHER, you understand that the time with the attorney is limited to your scheduled allotted time on the day of the Clinic. Any additional meeting time required outside of the allotted time, shall be billed at the attorney’s rate of $300.00/hour. If it becomes apparent and/or evident during the course of your estate planning meeting with the attorney that your plan is more complex than what the Simple Will Clinic will allow, that the attorney may cancel The Simple Will documents and provide a refund of your payment for The Simple Will Clinic; at which time, additional information may be obtained and a standard (1.5 hours) meeting can be arranged for a later time.

Reliability of Information Provided by You

You understand that if any information provided to our office – written or oral – are incorrect or missing, that you will be responsible for addressing the missing information with the attorney or assistant assigned to your case; and release The Law Offices of Jeffrey G. Marsocci, PLLC or its successors in interest from any information you failed to provide or any inaccurate information you did provide.

Confidentiality and Client Identification

You have informed us that, if you are a couple, you are married to each other or planning jointly. You both have read the foregoing and understand there are potential conflicts of interest between you in the estate planning process. You consent to having our firm represent both of you to prepare an estate plan and the documents specified herein. You understand that between yourself and us, there are no confidential communications because we represent both of you. Further, you understand that no attorney-client relationship exists between our office and your heirs, beneficiaries, assigns and/or creditors, and that our office owes no duty of any kind to said individuals. Our office will only communicate with your chosen financial and/or health care representatives at the appropriate time, and our office specifically will not communicate with any other heirs, beneficiaries, assigns and/or creditors except through such legally empowered representative(s).

Understanding

You understand that a fixed fee will be paid to legal counsel. You understand that once the computer documents are created, in either draft or final form, the fixed fee paid to the firm is nonrefundable.

Finally, you understand that we will maintain records of your case and one set of originals of your estate planning document(s) for a period of seven years from the date of the last action taken on your case.

If this agreement expresses your understanding of legal engagement, kindly indicate your consent at the bottom. This agreement accompanied by payment will constitute not only our understanding but also full authorization for us to act on your behalf as legal counsel for the matter referred to herein.

I/We agree to the terms listed above. I/We don't agree to the terms listed above.

Payment Information - Please complete the information listed below, or please contact us with your information at 919-844-7993.

Personal Information

Children - Please list all children that you have. *

Confidentiality and Client Identification

Understanding