Basic Estate Planning Package Form (GA Residents Only - $399)
* Your Estate will be divided equally between the people you designate as beneficiary recipients in this form - NO specified individual gifts
Personal Information
Name
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First and Middle Name
Last Name
Age
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Date of Birth
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Phone Number
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-
Area Code
Phone Number
Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
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example@example.com
Employer
Marital Status
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Single
Married
Divorced
Widowed
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Immediate Family Information
* ALL biological and adopted children MUST be listed, even if not chosen to be a beneficiary. Failure to do so can result in legal challenges and unwanted disbursements of your money, property and assets in your Estate and Last Will & Testament in Probate Court
Spouse's Name (If applicable)
1st Child Name & Age
2nd Child Name & Age
3rd Child Name & Age
4th Child Name & Age
5th Child Name & Age
6th Child Name & Age
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Final Wishes
Do you wish to be:
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Buried
Cremated
Leave it to the discretion of my Executor
Do you wish to have a:
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Funeral
Service
Both
Neither
Leave to the discretion of my Executor
Other
If you wish to have a Funeral and/or Service, where and/or what type?
How will your Funeral, Service, Burial, etc. be paid? (I.e. Reimbursement from your bank account, life insurance proceeds, final expense policy, etc.)
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Please name the Company that holds these funds and/or policy
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Appointments and Designations
Last Will & Testament
Executor Name
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Executor - Person that will handle all of your affairs upon your passing, file your Will in Probate Court and distribute your money and property to your beneficiaries
Successor Executor Name
Successor Executor - Person that will handle all of your affairs upon your passing, file your Will in Probate Court and distribute your money and property to your beneficiaries in the event your named Executor is unable or unwilling to do so
Guardian Name (If you have Minor or Special Needs Children)
Guardian - Person that will take care of and raise your minor child(ren) or incapacitated adult if you and child's other biological parent both pass
Successor Guardian Name (If you have Minor or Special Needs Children)
Successor Guardian -Person that will take care of and raise your minor child(ren) or incapacitated adult in the event that your named Guardian is unable or unwilling to do so
Trustee Name (Only If you have Minor or Special Needs Children)
Trustee - Person that is responsible for handling and distributing assets to your minor or special needs children according to the terms of your Trust
Successor Trustee Name (Only if you have Minor or Special Needs Children)
Successor Trustee - Person that is responsible for handling and distributing assets to your minor or special needs children according to the terms of your Trust in the event that your named Trustee is unable or unwilling to do so
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Beneficiaries
List the NAMES of the Beneficiaries that you wish for your estate to be divided equally between (i.e. Name of spouse, children, parents, siblings, etc.)
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*All money, assets and property will be divided equally among your beneficiaries by your named Executor at his/her discretion. Individual items are not gifted in this Basic Estate Planning Package
Special Circumstances (Include special requests or situations in this section):
If you wish to gift specific money, items or property to a certain person(s), then you will need to upgrade to an Enhanced Estate Planning Package. A consultation with our Attorney is required for an Enhanced Package and cannot be obtained through this Form
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Power of Attorney
Appointment & Designation
Name of Power of Attorney Agent
Person that will handle your personal and business affairs in the event that you are incapacitated. Requires 2 physician verifications to be effective. Power of Attorney cannot make Healthcare decisions for you.
Power of Attorney Phone Number
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Area Code
Phone Number
Power of Attorney Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Successor Power of Attorney
Person that will handle your personal and business affairs in the event that you are incapacitated and the named Power of Attorney is unable or unwilling to do so. Requires 2 physician verifications to be effective.
Successor Power of Attorney Phone Number
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Area Code
Phone Number
Successor Power of Attorney Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
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Advance Directive for Healthcare
Appointment & Designation
Healthcare Agent
Person that will make healthcare decisions on your behalf in the event that you become incapacitated
Healthcare Agent Phone Number
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Area Code
Phone Number
Healthcare Agent Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Successor Healthcare Agent
Person that will make healthcare decisions on your behalf in the event that you become incapacitated and the named Healthcare Agent is unable or unwilling to do so
Successor Healthcare Agent Phone Number
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Area Code
Phone Number
Successor Healthcare Agent Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
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Acknowledgement
Please read, review and check each item below prior to completing
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I acknowledge that I have completed this Form freely and voluntarily;
I acknowledge that I will hold T. M. Johnson Law Firm, LLC harmless for any errors that I enter into this form and that was relied upon in the creation of my Basic Estate Planning documents;
I acknowledge and understand that even by completing this Form and having my Basic Estate Planning Package prepared, no attorney client relationship has been created;
I acknowledge and represent that I have correctly listed my spouse (even if separated) and ALL of my biological and adopted children, even if I haven't listed them as a beneficiary;
I acknowledge that I am a resident of the State of Georgia.
SIGNATURE
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Submit
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