Estate Planning: 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 Name

Client One: Date of Birth

Client One: U.S. Citizen?

Yes
No

Client One: U.S. Veteran?

Yes
No

Client One: Years of Military Service

Client One: "Signature Name"

*print your name the way you sign important papers

Client One: Home Phone

Client One: Cell Phone

Client One: Email

Client Two

Client Two: Full Name

Client Two: Date of Birth

Client Two: U.S. Citizen?

Yes
No

Client Two: U.S. Veteran?

Yes
No

Client Two: Years of Military Service

Client Two: "Signature Name"

*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

Children:

Child One: Full 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

Parent of Child One

Client One
Client Two
Both

Status of Child One

Living
Deceased
Special Needs

Child One: Number of Children (Your Grandchildren)

Child Two: Full 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

Parent of Child Two

Client One
Client Two
Both

Status of Child Two

Living
Deceased
Special Needs

Child Two: Number of Children (Your Grandchildren)

Child Three: Full 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

Parent of Child Three

Client One
Client Two
Both

Status of Child Three

Living
Deceased
Special Needs

Child Three: Number of Children (Your Grandchildren)

Child Four: Full 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

Parent of Child Four

Client One
Client Two
Both

Status of Child Four

Living
Deceased
Special Needs

Child Four: Number of Children (Your Grandchildren)

Child Five: Full 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

Parent of Child Five

Client One
Client Two
Both

Status of Child Five

Living
Deceased
Special Needs

Child Five: Number of Children (Your Grandchildren)

Child Six: Full 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

Parent of Child Six

Client One
Client Two
Both

Status of Child Six

Living
Deceased
Special Needs

Child Six: Number of Children (Your Grandchildren)

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

My estate has the following assets:

Real Estate
IRA/Retirement Plans
Partnerships
Stocks, Bonds, Mutual Funds
Life Insurance
Cash Accounts (checking, savings, CDs etc.)

Approximate gross value of my entire estate:

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: