Estate Planning: Initial Consultation Form

Please complete this client information form prior to your initial Estate Planning Consultation.

Initial Consultation Form

Consultation Date:
Marital Status:
- Married
- Widowed
- Single
- Divorced
If Married, Date of Marriage:
If Widowed, Date of Death:
Client One
Client One: Full Legal Name
Client One: Date of Birth
Client One: U.S. Citizen? (needed as different laws may apply)
- Yes
- No
Client One: U.S. Veteran? (needed to determine VA benefit eligibility)
- Yes
- No
Client One: Years of Military Service (needed to determine VA benefit eligibility)
Client One: "Signature Name" (Type your name the way you typically sign important papers)
Client One: Home Phone
Client One: Cell Phone
Client One: Email
Client Two
Client Two: Full Legal Name
Client Two: Date of Birth
Client Two: U.S. Citizen? (needed as different laws may apply)
- Yes
- No
Client Two: U.S. Veteran? (needed to determine VA benefit eligibility)
- Yes
- No
Client Two: Years of Military Service (needed to determine VA benefit eligibility)
Client Two: "Signature Name" (Type your name the way you typically sign important papers)

*print your name the way you sign important papers
Client Two: Home Phone
Client Two: Cell Phone
Client Two: Email
Address:
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country of Citizenship
County of Residence
My estate has the following assets:
- GA Real Estate
- Out of State Real Estate
- IRA/Retirement Plans
- Annuities
- Partnerships/Business Interests
- Stocks, Bonds, Mutual Funds
- Life Insurance
- Cash Accounts (checking, savings, CDs etc.)
Approximate gross value of my entire estate:
- $100,000-$250,000
- $250,000-$500,000
- $500,000-$1,000,000
- $1,000,000+
Children:
Child One: Full Legal Name
Child One: Sex
- Male
- Female
Child One: Date of Birth
Child One: Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Child One: Home Phone
Child One: Cell Phone
Child One: Email
Who is the Parent of Child One?
- Client One
- Client Two
- Both
Status of Child One
- Living
- Deceased
- Special Needs
How many children does Child One have?
Child Two: Full Legal Name
Child Two: Sex
- Male
- Female
Child Two: Date of Birth
Child Two: Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Child Two: Home Phone
Child Two: Cell Phone
Child Two: Email
Who is the Parent of Child Two?
- Client One
- Client Two
- Both
Status of Child Two
- Living
- Deceased
- Special Needs
How many children does Child Two have?
Child Three: Full Legal Name
Child Three: Sex
- Male
- Female
Child Three: Date of Birth
Child Three: Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Child Three: Home Phone
Child Three: Cell Phone
Child Three: Email
Who is the Parent of Child Three?
- Client One
- Client Two
- Both
Status of Child Three
- Living
- Deceased
- Special Needs
How many children does Child Three have?
Child Four: Full Legal Name
Child Four: Sex
- Male
- Female
Child Four: Date of Birth
Child Four: Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Child Four: Home Phone
Child Four: Cell Phone
Child Four: Email
Who is the Parent of Child Four?
- Client One
- Client Two
- Both
Status of Child Four
- Living
- Deceased
- Special Needs
How many children does Child Four have?
Child Five: Full Legal Name
Child Five: Sex
- Male
- Female
Child Five: Date of Birth
Child Five: Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Child Five: Home Phone
Child Five: Cell Phone
Child Five: Email
Who is the Parent of Child Five?
- Client One
- Client Two
- Both
Status of Child Five
- Living
- Deceased
- Special Needs
How many children does Child Five have?
Child Six: Full Legal Name
Child Six: Sex
- Male
- Female
Child Six: Date of Birth
Child Six: Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Child Six: Home Phone
Child Six: Cell Phone
Child Six: Email
Who is the Parent of Child Six?
- Client One
- Client Two
- Both
Status of Child Six
- Living
- Deceased
- Special Needs
How many children does Child Six have?
Financial:
Financial Advisor: Name
First Last
Financial Advisor: Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Financial Advisor: Phone
Financial Advisor: Fax
Financial Advisor: Email
Accountant: Name
First Last
Accountant: Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Accountant: Phone
Accountant: Fax
Accountant: Email
Please check one of the following boxes:
- I am ready to proceed with Option #1 (Living Trust and associated documents)
- I am ready to proceed with Option #2 (Last Will and Testament and associated documents)
- I am ready to proceed with one or more estate planning documents (Financial Power of Attorney, Health Care Directive, etc.)
- I need the following questions answered before I am ready to proceed with the creation of any estate planning documents.
Please list any estate planning goals and objectives that you wish to achieve (i.e. staying in control of your affairs, selecting your personal representatives, ensuring that your estate is distributed according to your wishes, saving money on estate taxes, etc.)

Estate Planning: Initial Consultation Form

Please complete this client information form prior to your initial Estate Planning Consultation.

Initial Consultation Form

Client One

Client Two

Address:

Children:

Financial: