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Client Information

First Name

Last Name

Middle Name / Initial

Suffix (Jr., Sr., III, etc.)

Date of Birth

Citizenship Status

Street Address

City

State

ZIP Code

Phone Number

Email Address

Occupation

Employer

Marital Status

Prior Marriages?

Please explain (dates, names, how ended, any obligations):

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Spouse / Partner Information

Full Legal Name

Date of Birth

Occupation

Employer

Date of Marriage

Place of Marriage

Does your spouse/partner have prior marriages?

If yes, please explain:

Do you and your spouse/partner plan to have the same estate plan, or separate documents?

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Children & Dependents

Important: Please list ALL children, including adult children, minor children, stepchildren, and any legally adopted children. Include children from prior relationships.

Full Name	Date of Birth	Relationship	Address (if adult)	Special Needs?	Action

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Retirement Accounts

Institution	Account Type	Owner	Balance	Beneficiary	Action

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Life Insurance Policies

Company	Type	Insured	Death Benefit	Beneficiary	Action

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Business Interests

Do you own any business interests?

Business Name

Ownership %

Approximate Value

Succession Plan or Buy-Sell Agreement?

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Other Assets

Vehicles, Jewelry, Art, Collectibles, Cryptocurrency, etc.

Please list any other valuable assets:

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Liabilities

Mortgages, Loans, Credit Cards, Other Debts

Please list any significant debts or obligations:

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Estate Planning Goals & Intentions

What would a successful estate plan look like for you?

What are your biggest concerns about your current situation?

What would you like to ensure never happens after your death?

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Trust Planning

Are you interested in creating a trust?

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Beneficiaries & Distribution

Primary Beneficiaries (names and % shares)

Contingent Beneficiaries (if primary cannot inherit)

Specific Gifts

Charitable Gifts

At what age(s) should beneficiaries receive their inheritance?

Distribution timing details:

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Fiduciary Appointments

Role	Primary	Alternate	Relationship
Executor
Trustee
Healthcare Agent
Financial Agent
Guardian (minors)

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Health Care & End-of-Life Wishes

Life-sustaining treatment preferences:

Organ donation:

If specific organs, which ones?

Funeral or burial preferences:

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Existing Documents

Do you currently have:

Will

Trust

Health Care POA

Financial POA

None

When created?

Where stored?

Why are you updating now?

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Additional Notes

Anything else we should know?

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Professional Contacts

CPA / Accountant

Contact

Financial Advisor

Contact

How did you hear about us?

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Authorization & Signature

Certification: I certify that the information provided is true and accurate to the best of my knowledge. I understand this information will be used to prepare estate planning documents and is confidential and protected by attorney-client privilege.

Client Signature

Date

Client Forms

🩵 Estate Planning Questionnaire