Estate Planning Client Data

Client

Client Marital Status

Client First Name

Client Last Name

Client Address Line

Client City

Client State

Client Zip

Client Phone Number

Client Email Address

Spouse (if applicable)

Spouse First Name

If applicable

Spouse Last Name

If applicable

Spouse Phone Number

Spouse Email Address

Please note: you need to enter a person’s complete contact details only once. If you want to assign the same individual to multiple “estate roles,” you only need to enter his/her name in the subsequent sections.

Children (if applicable)

First Child

First Name – 1st Child

1st Born Child

Last Name – 1st Child

Address – 1st Child

City – 1st Child

State – 1st Child

Zip – 1st Child

Phone Number – 1st Child

Email Address – 1st Child

Second Child

First Name – 2nd Child

2nd Born Child (if applicable)

Last Name – 2nd Child

Address Line – 2nd Child

City – 2nd Child

State – 2nd Child

Zip – 2nd Child

Phone Number – 2nd Child

Email Address – 2nd Child

Third Child

First Name – 3rd Child

3rd Born Child (if applicable)

Last Name – 3rd Child

Address Line – 3rd Child

City – 3rd Child

State – 3rd Child

Zip – 3rd Child

Phone Number – 3rd Child

Email Address- 3rd Child

Fourth Child

First Name – 4th Child

4th Born Child (if applicable)

Last Name – 4th Child

Address Line – 4th Child

City – 4th Child

State – 4th Child

Zip – 4th Child

Phone Number – 4th Child

Email Address – 4th Child

Health Care Proxy (HCP) for Medical Decisions

Primary HCP

First Name – Primary HCP

Primary Health Care Proxy (HCP)

Last Name – Primary HCP

Address Line – Primary HCP

City – Primary HCP

State – Primary HCP

Zip – Primary HCP

Phone Number – Primary HCP

Secondary HCP

First Name – Secondary HCP

Secondary Health Care Proxy (HCP)

Last Name – Secondary HCP

Address Line – Secondary HCP

City – Secondary HCP

State – Secondary HCP

Zip – Secondary HCP

Phone Number – Secondary HCP

Tertiary HCP

First Name – Tertiary HCP

Tertiary Health Care Proxy (HCP)

Last Name – Tertiary HCP

Address Line – Tertiary HCP

City – Tertiary HCP

State – Tertiary HCP

Zip – Tertiary HCP

Phone Number – Tertiary HCP

If you would like to list additional proxies, please enter their information below:

Power of Attorney for Banking, Financial, and many “Other” Decisions

Primary Agent 1

First Name – Primary Agent #1

Power of Attorney (POA)

Last Name – Primary Agent #1

Address Line – Primary Agent #1

City – Primary Agent #1

State – Primary Agent #1

Zip – Primary Agent #1

Phone Number – Primary Agent #1

Email Address – Primary Agent #1

Primary Agent 2 (if you want more than one primary agent)

First Name – Primary Agent #2

Power of Attorney (POA)

Last Name – Primary Agent #2

Address Line – Primary Agent #2

City – Primary Agent #2

State – Primary Agent #2

Zip – Primary Agent #2

Phone Number – Primary Agent #2

Email Address – Primary Agent #2

If you would like to list additional Primary Agents, please enter their information below:

Power of Attorney – Successor Agents (to act only if the Primary Agents cannot act)

Successor Agent 1

First Name – Successor Agent #1

Power of Attorney Successor Agent (POAS)

Last Name – Successor Agent #1

Address Line – Successor Agent #1

City – Successor Agent #1

State – Successor Agent #1

Zip – Successor Agent #1

Phone Number – Successor Agent #1

Email Address – Successor Agent #1

Successor Agent 2 (if you want more than one Successor Agent)

First Name – Successor Agent #2

Power of Attorney Successor Agent (POAS)

Last Name – Successor Agent #2

Address Line – Successor Agent #2

City – Successor Agent #2

State – Successor Agent #2

Zip – Successor Agent #2

Phone Number – Successor Agent #2

Email Address – Successor Agent #2

If you would like to list additional Successor Agents, please enter their information below:

Executors (in charge of probating your Will, distributing your assets to your beneficiaries, paying your expenses, managing the estate, etc.)

Executor

First Name – Executor

Executor of the Will

Last Name – Executor

Address Line – Executor

City – Executor

State – Executor

Zip – Executor

Co-Executor (if you want 2 or more executors to act together)

First Name – Co-Executor

Co-Executor of the Will | You can appoint co-executors if you'd like 2+ persons to act together

Last Name – Co-Executor

Address Line – Co-Executor

City – Co-Executor

State – Co-Executor

Zip – Co-Executor

If you would like to list additional Co-Executors, please enter their information below:

Successor Executor (to act only if the “primary” executor(s) cannot act)

First Name – Successor Executor

Successor Executor (ES)

Last Name – Successor Executor

Address Line – Successor Executor

City – Successor Executor

State – Successor Executor

Zip – Successor Executor

Successor Co-Executor (if you want more than one successor executor)

First Name – Successor Co-Executor

Successor Co-Executor (ES) | You can appoint successor co-executors if you'd like 2+ persons to act together

Last Name – Successor Co-Executor

Address Line – Successor Co-Executor

City – Successor Co-Executors

State – Successor Co-Executors

Zip – Successor Co-Executors

If you would like to list additional Successor Co-Executors, please enter their information below:

Trustee (in charge of managing your Revocable and/or Irrevocable Trust)

Initial Trustee

First Name – Trustee

Trustee

Last Name – Trustee

Address Line – Trustee

City – Trustee

State – Trustee

Zip – Trustee

Co-Trustee (if you want 2 or more initial trustees to act together)

First Name – Primary Co-Trustee #2

Primary Co-Trustee #2 | You can appoint co-trustees if you'd like 2+ persons to act together

Last Name – Primary Co-Trustee #2

Address Line – Primary Co-Trustee #2

City – Primary Co-Trustee #2

State – Primary Co-Trustee #2

Zip – Primary Co-Trustee #2

If you would like to list additional Primary Co-Trustees, please enter their information below:

Successor Trustee (to act only if the initial trustee(s) cannot act)

First Name – Successor Trustee

Successor Trustee (ST)

Last Name – Successor Trustee

Address Line – Successor Trustee

City – Successor Trustee

State – Successor Trustee

Zip – Successor Trustee

Successor Co-Trustee (if you want more than one successor trustee)

First Name – Successor Co-Trustee #2

Successor Co-Trustee (ST) | You can appoint successor co-trustees if you'd like 2+ persons to act together

Last Name – Successor Co-Trustee #2

Address Line – Successor Co-Trustee #2

City – Successor Co-Trustee #2

State – Successor Co-Trustee #2

Zip – Successor Co-Trustee #2

If you would like to list additional Successor Co-Trustees, please enter their information below:

Standby Guardians for Minor Children

Primary Standby Guardian

First Name – SG

Standby Guardian (SG)

Last Name – SG

Address Line – SG

City – SG

State – SG

Zip – SG

2nd Standby Guardian

First Name – 2nd SG

Second Standby Guardian (SG)

Last Name – 2nd SG

Address Line – 2nd SG

City – 2nd SG

State – 2nd SG

Zip – 2nd SG

If you would like to list additional Standby Guardians, please enter their information below:

Additional Comments and/or Instructions

Client

Spouse (if applicable)

Please note: you need to enter a person’s complete contact details only once. If you want to assign the same individual to multiple “estate roles,” you only need to enter his/her name in the subsequent sections.

Children (if applicable)

First Child

Second Child

Third Child

Fourth Child

Health Care Proxy (HCP) for Medical Decisions

Primary HCP

Secondary HCP

Tertiary HCP

Power of Attorney for Banking, Financial, and many “Other” Decisions

Primary Agent 1

Primary Agent 2 (if you want more than one primary agent)

Power of Attorney – Successor Agents (to act only if the Primary Agents cannot act)

Successor Agent 1

Successor Agent 2 (if you want more than one Successor Agent)

Executors (in charge of probating your Will, distributing your assets to your beneficiaries, paying your expenses, managing the estate, etc.)

Executor

Co-Executor (if you want 2 or more executors to act together)

Successor Executor (to act only if the “primary” executor(s) cannot act)

Successor Co-Executor (if you want more than one successor executor)

Trustee (in charge of managing your Revocable and/or Irrevocable Trust)

Initial Trustee

Co-Trustee (if you want 2 or more initial trustees to act together)

Successor Trustee (to act only if the initial trustee(s) cannot act)

Successor Co-Trustee (if you want more than one successor trustee)

Standby Guardians for Minor Children

Primary Standby Guardian

2nd Standby Guardian

Abraham Mazloumi & Associates

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