Full Name
*
Date Completed
*
Trust Name (if applicable)
*
Phone Number
*
Email Address
*
Address
*
Street Address
*
City
*
State
*
Country
*
Country
Postal Code
*
Marital Status
*
Single
Married
Divorced
Legally Separated
Annulled
Common-Law / Live-in
Domestic Partnership
Spouse Full Legal Name (if married)
*
Do you have children under 18?
*
Yes
No
1st Child Full Name
*
1st Child Age
*
2nd Child Full Name
2nd Child Age
3rd Child Full Name
3rd Child Age
4th Child Age
4th Child Full Name
5th Child Age
5th Child Full Name
Do you own this asset?
*
Yes
No
Bank / Institution Name
*
Name on Account
*
Account Type
*
Approx Balance
*
$
Do you own real estate?
*
Yes
No
Property Address
*
Title (How ownership is held)
*
Market Value
*
$
Mortgage Balance
*
$
Do you own investments?
*
Yes
No
Brokerage Name
*
Account Number (last 4)
*
Approx Value
*
$
Do you have retirement accounts?
*
Yes
No
Institution
*
Retirement Account Type
*
Named Beneficiary
*
Retirement Approx Balance
*
$
Do you have life insurance?
*
Yes
No
Insurance Company
*
Policy Number
*
Death Benefit
*
Life insurance Named Beneficiary
*
Do you have annuities?
*
Yes
No
Annuities Company
*
Policy / Contract Number
*
Annuities Type
*
Current Value
*
$
Do you own a business?
*
Yes
No
Interests Business Name
*
Interests Ownership %
*
Interests Entity Type
*
Interests Estimated Value
*
$
Do you have valuable personal property?
*
Yes
No
Property Description
*
Property Approx Value
*
$
Property Ownership Details
*
Do you own digital assets?
*
Yes
No
Platform / Asset
*
Assets Approx Value
*
$
Access / Recovery Location
*
Is money owed to you?
*
Yes
No
Debtor Name
*
Receivable Amount
*
$
Receivable Terms
*
Do you have other assets?
*
Yes
No
Other Assets Description
*
Other Assets Estimated Value
*
$
Other Assets Ownership
*
Additional Estate Concerns
*
Mortgage Balances
*
$
Personal Loans
*
$
Credit Cards
*
$
Business Debts
*
$
Other Liabilities
*
Do you want to assign specific gifts?
*
Yes
No
Recipient Name
*
1st Recipient Name
2nd Recipient Name
3rd Recipient Name
4th Recipient Name
5th Recipient Name
Specific Distributions Relationship
*
1st Recipient Relationship
2nd Recipient Relationship
3rd Recipient Relationship
4th Recipient Relationship
5th Recipient Relationship
Description of Gift
*
1st Recipient Description of Gift
2nd Recipient Description of Gift
3rd Recipient Description of Gift
4th Recipient Description of Gift
5th Recipient Description of Gift
Estimated Value / %
*
1st Recipient Estimated Value / %
2nd Recipient Estimated Value / %
3rd Recipient Estimated Value / %
4th Recipient Estimated Value / %
5th Recipient Estimated Value / %
Do you want to gift your business?
*
Yes
No
Gift Business Name
*
Gift Beneficiary
*
Gift % Ownership
*
Do you want to include charity?
*
Yes
No
Charity Organization Name
*
Charity EIN (optional)
Charity Gift Amount / %
*
Special Notes
*
After all gifts, who receives the rest?
*
Full Legal Name
Relationship
% Share
Alternate if deceased
⚠️ TOTAL MUST = 100%
DISTRIBUTION METHOD
*
Per Stirpes
Per Capita
CONTINGENT BENEFICIARY
*
Name
Type (Person / Organization)
Relationship / EIN
ADDITIONAL NOTES
*
Do you want conditions?
*
Yes
No
Condition (age, milestone, etc.)
*
Condition Beneficiary
*
Condition Asset / Amount
*
SUCCESSOR TRUSTEE: 1st Choice
*
Full Name
Relationship
Phone
Email
City/State
SUCCESSOR TRUSTEE: 2nd Choice
Full Name
Relationship
Phone
Email
City/State
EXECUTOR: 1st Choice
*
Full Name
Relationship
Phone
Email
City/State
EXECUTOR: 2nd Choice
Full Name
Relationship
Phone
Email
City/State
POWER OF ATTORNEY (FINANCIAL): 1st Choice
*
Full Name
Relationship
Phone
Email
City/State
POWER OF ATTORNEY (FINANCIAL): 2nd Choice
Full Name
Relationship
Phone
Email
City/State
HEALTHCARE PROXY: 1st Choice
*
Full Name
Relationship
Phone
Email
City/State
HEALTHCARE PROXY: 2nd Choice
Full Name
Relationship
Phone
Email
City/State
Do you have minor children?
*
Yes
No
Minor Children 1st Choice:
*
Full Name
Relationship
Phone
Email
City/State
Minor Children 2nd Choice:
Full Name
Relationship
Phone
Email
City/State
TRUSTEE FOR MINORS
*
Name
Relationship
Phone
SPECIAL CONFLICTS / NOTES
*
Life support preference
*
Medical decisions instructions
*
Organ donation
*
Yes
No
Pet care instructions
*
Funeral wishes
*
Message to beneficiaries
*
LEGAL CONFIRMATION:
*
“I confirm all information is accurate”
Digital Signature
*
Clear
Print Name
*
Date Signed (Estate Form)
*
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