Estate Planning Form

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– Step 1 of 6

PERSONAL INFORMATION

Enter your personal information.

NAME

ADDRESS:

Address Line 1

City

State

Zip Code

PHONE NUMBER:

SOCIAL SECURITY NUMBER:

Used to get an EIN for Trust (Enter numbers only. no symbols.)

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POWER OF ATTORNEY

If you were unable to make financial decisions for yourself, who would you want to make those decisions for you?

Successor Name:

If the above-referenced agent is unwilling or unable to serve, who would you appoint?

Successor Name 2:

Effectiveness

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MEDICAL POWER OF ATTORNEY

In the event you are unable to make or communicate decisions about any aspects of your health care, who would you want to make those decisions for you?

Name

Successor Name

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LIVING WILL

In the event that the only procedure I am being provided is artificial nourishment, I direct that one of the following actions be taken:

Artificial nourishment will not be continued when it is the only procedure being provided.
Artificial nourishment will be continued for ________ days when it is the only procedure being provided
Artificial nourishment will be continued when it is the only procedure being provided.

Number of days

Enter the number of days.

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WILL

Upon your death, your Will names an individual(s) to manage your estate and to distribute your personal property according to the instructions provided.

SPOUSE
CHILDREN
GUARDIAN
BURIAL INSTRUCTIONS
PERSONAL REPRESENTATIVE
SUCCESSOR PERSONAL REPRESENTATIVE

Instructions (Spouse)

Instructions (Children)

Instructions (Guardian)

Instructions (Burial)

Instructions (Personal Representative)

Instructions (Successor Personal Representative)

TANGIBLE PROPERTY

Who do you want to give your personal property to? Example: Car, Jewelry, Antiques… etc.

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TRUST AGREEMENT

The Trust Agreement is the foundation of your estate plan. It contains instructions for your own care and the care of your family should you become disabled, and for the distribution of your assets upon your death.

PLEASE PROVIDE A NAME FOR YOUR TRUST

ADDRESS OF RESIDENCE

Address Line 1

City

State

Zip Code

Please explain how you want this property distributed:

ADDRESS OF RENTAL PROPERTY

Address Line 1

City

State

Zip Code

Please provided an LLC name for this property:

Please explain how you want this property distributed:

NAME OF TRUSTEE(S) UPON DEATH

Other Assets

Please tell us about other assets you would like to add to your Trust including the last four digits of the account: Example, Bank Accounts, Stocks, Bonds, Insurance Policies…etc.

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Estate Planning Form

PERSONAL INFORMATION

POWER OF ATTORNEY

MEDICAL POWER OF ATTORNEY

LIVING WILL

WILL

TRUST AGREEMENT

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