Estate Planning Information Form

Step 1 of 7

  • Select date MM slash DD slash YYYY
  • 0 of 2 max characters
  • By answering the following key questions, you will help with the information we need to create your personalized Estate Planning. There are many options and each of these questions ensure we create a Will, Healthcare Proxy, and Power of Attorney that reflects your wishes. Answering all information will allow us to identify any risks that the simple plan you are opting for is best to accomplish your goals.

  • Please rank the level of importance to you on each of the following issues (1 = Low 10 = High)
  • Please enter a number from 1 to 10.
  • Please enter a number from 1 to 10.
  • Please enter a number from 1 to 10.
  • Please enter a number from 1 to 10.
    (i.e. my spouse's disability or remarriage, my children's/beneficiary's lawsuits, divorce or bankruptcy)
  • Please enter a number from 1 to 10.
  • Please enter a number from 1 to 10.
  • Please enter a number from 1 to 10.
  • Please enter a number from 1 to 10.
  • Current Information

  • Current Health

  • Personal Financial Information

    It is very important you indicate in each category ownership and dollar amount separately, as well as total value.
  • Your Monthly Income

  • Spouse Monthly Income

  • Joint Monthly Income

  • Total Monthly Income

  • Asset Information

    Please provide total amount for each type of asset and who owns.
  • Select date MM slash DD slash YYYY
  • Your Asset Information

  • Annuities

  • Spouse Asset Information

  • Annuities

  • Joint Asset Information

  • Annuities

  • Total Asset Information

  • Annuities