Legacy Profile w/ Consult Start building your legacy and protecting your assets today. 1About You2Children & Other Heirs3Assets4General Durable Power of Attorney5Healthcare Power of Attorney6Living Will7Last Will and Testament8Trust9Ladybird Deed10Submit This field is hidden when viewing the formAbout YouAbout YouYour Name(Required) First Middle Last Suffix Date of Birth(Required) MM slash DD slash YYYY Your Address Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Your Phone(Required)Your Email Address(Required) Email Address Confirm Email Address Are you married?(Required) Yes No About Your SpouseSpouse's Name(Required) First Middle Last Suffix Spouse's Date of Birth(Required) MM slash DD slash YYYY Client Info Notes Children and HeirsIn this section you will list your children and other heirs.Children of Current MarriageDo you and your spouse have children together? Yes No Children of Current Marriage First Name Middle Name Last Name Suffix Birthdate Minor or Adult Actions Edit Delete There are no Children. Add Child Maximum number of children reached. Your Children from Previous RelationshipsDo you have children from previous relationships? Yes No Children of Previous Relationships First Name Middle Name Last Name Suffix Birthdate Minor or Adult Actions Edit Delete There are no Children. Add Child Maximum number of children reached. Spouse’s Children from Previous RelationshipsDoes spouse have children from previous relationships? Yes No Children of Spouse's Previous Relationships First Name Middle Name Last Name Suffix Birthdate Minor or Adult Actions Edit Delete There are no Children. Add Child Maximum number of children reached. Additional Heirs (Other than children listed above)Do you wish to designate other heirs (such as relatives, friends, or charities)? Yes No Additional Heirs Is this heir an individual or a charity? Individual Heir Name Charity Name Distribution (%) or Specific Asset to Heir Percentage of Estate to Heir Describe/Name Specific Asset to Heir Actions Edit Delete There are no Additional Heirs. Add Additional Heir Maximum number of additional heirs reached. Children and Heirs Notes Asset InformationIn this section you will list assets to be considered in crafting a plan and in both protecting and passing these assets.Real EstateReal property will be listed here. While you will be indicating your primary residence you will want to include any interest in any real property you or you and your spouse may own.Do you own real estate? Yes No Real Property Owned Real Estate Parcel Address Parcel Classification Estimated Value $ Actions Edit Delete There are no Real Properties. Add Real Property Maximum number of real properties reached. Retirement AccountsHere you will list your retirement accounts such as IRA’s, 401k’s, Tax Qualified Annuities, etc. Traditional pensions should not be included in this sections as they are technically income and not considered an asset.Do you have retirement accounts? Yes No Retirement Accounts Retirement Account Type Approximate Value $ Actions Edit Delete There are no Retirement Accounts. Add Retirement Account Maximum number of retirement accounts reached. Investment Accounts / Liquid AssetsDo you have investment accounts? Yes No Investment Accounts Investment Account Type (Brokerage, Savings, etc.) Approximate Value $ Actions Edit Delete There are no Investment Accounts. Add Investment Account Maximum number of investment accounts reached. Insurance Policies & AnnuitiesDo you have life insurance policies or annuities? Yes No Insurance Policies and Annuities Type (Life Insurance, Annuity) Company Approximate Death Benefit or Value $ Actions Edit Delete There are no Insurance Policies or Annuities. Add Insurance Policies or Annuity Maximum number of insurance policies or annuities reached. Asset Notes This field is hidden when viewing the formGeneral Durable Power of AttorneyLegacy BuildingIn this section you will examne who are the best choices to help operate your life if something to keep you safe during your life and who is best suited to handle your affairs should you pass away. We will also examine the people in your life and assets to protect and to leave to loved ones. Your General Durable Power of AttorneyA General Durable Power of Attorney empowers you to appoint an agent to handle your financial and legal affairs should you ever need someone to step in and assist. A General Durable Power of Attorney also serves to prevent s Guardianship by the court by proactively appointing an individual of your choosing.Include General Durable Power of Attorney?(Required) Yes No Primary Financial Agent First Middle Last Suffix This is your first choice to handle your financial and legal affairs if you are in a position where you may need someone to step in and assist.Initial Financial AgentsFirstMiddleLastSuffix Add RemoveThese are your first choice to handle your financial and legal affairs if you are in a position where you may need someone to step in and assist. They serve with independent authority. Add at least one.Successor Financial Agent First Middle Last Suffix This is your second choice to handle your financial and legal affairs if you are in a position where you may need someone to step in and assist.Successor Financial Agent Additional First Middle Last Suffix This is your third choice to handle your financial and legal affairs if you are in a position where you may need someone to step in and assist.Successor Financial AgentsFirstMiddleLastSuffix Add RemoveThis is your second choice to handle your financial and legal affairs if you are in a position where you may need someone to step in and assist.Successor Financial Agent Priority Successor agents serve consecutively in the order listed Successor agents act with independent authority Is this General Durable Power of Attorney Springing?(Required)A Springing General Durable Power of Attorney only gives powers to an Agent when a condition is met. In this case, whether 1 or 2 physicians confirm in writing or by affidavit that the Principal is incompetent or incapacitated and cannot preform their financial and legal duties on their own. Yes No Number of Physicians who Must Verify Incompetence or Incapacity?(Required)Will you require 1 or 2 physicians to confirm in writing or by affidavit that the you are incompetent or incapacitated and cannot preform your financial and legal duties on their own before the Agent’s powers are activated? 1 Physician 2 Physicians Prepare GDPOA? Yes No Springing? Yes No Physician Affidavits Required? 1 Physician Affidavit 2 Physician Affidavits Does GDPOA survive Divorce? GDPOA Survives Divorce GDPOA Does NOT Survive Divorce Spouse's General Durable Power of AttorneyA General Durable Power of Attorney empowers you to appoint an agent to handle your financial and legal affairs should you ever need someone to step in and assist. A General Durable Power of Attorney also serves to prevent s Guardianship by the court by proactively appointing an individual of your choosing.Include Spouse's General Durable Power of Attorney?(Required) Yes No Spouse's Primary Financial Agent First Middle Last Suffix This is your first choice to handle your financial and legal affairs if you are in a position where you may need someone to step in and assist.Spouse's Successor Financial Agent First Middle Last Suffix This is your second choice to handle your financial and legal affairs if you are in a position where you may need someone to step in and assist.Spouse's Successor Financial Agent Additional First Middle Last Suffix This is your second choice to handle your financial and legal affairs if you are in a position where you may need someone to step in and assist.Spouse's Successor Financial Agent Priority Successor agents server in the order listed Successor agents act jointly Is Spouse's General Durable Power of Attorney Springing?(Required)A Springing General Durable Power of Attorney only gives powers to an Agent when a condition is met. In this case, whether 1 or 2 physicians confirm in writing or by affidavit that the Principal is incompetent or incapacitated and cannot preform their financial and legal duties on their own. Yes No Number of Physicians who Must Verify Incompetence or Incapacity of Spouse?(Required)Will you require 1 or 2 physicians to confirm in writing or by affidavit that the you are incompetent or incapacitated and cannot preform your financial and legal duties on their own before the Agent’s powers are activated? 1 Physician Affidavit 2 Physician Affidavits Prepare Spouse's GDPOA? Yes No Is Spouse's GDPOA Springing? Yes No Physician Affidavits Required for Spouse? 1 Physician Affidavit 2 Physician Affidavits Does Spouse's GDPOA survive Divorce? GDPOA Survives Divorce GDPOA Does NOT Survive Divorce This field is hidden when viewing the formHealthcare Power of AttorneyYour Healthcare Power of AttorneyA Healthcare Power of Attorney empowers you to appoint an agent to handle your healthcare should you ever need someone to step in and assist. A Healthcare Power of Attorney also serves to prevent s Guardianship by the court by proactively appointing an individual of your choosing. A healthcare power of attorney is automatically Springing and the Agent only has powers if the Principal is unable to make their own healthcare decisions.Include Healthcare Power of Attorney?(Required) Yes No Primary Healthcare Agent First Middle Last Suffix This is your first choice to handle your financial and legal affairs if you are in a position where you may need someone to step in and assist.Successor Healthcare Agent First Middle Last Suffix This is your second choice to handle your financial and legal affairs if you are in a position where you may need someone to step in and assist.Disposition of the BodyA Healthcare Power of Attorney allows you to choose burial or cremation. What would be your choice when the time comes? Burial Cremation Other Prepare HCPOA? Yes No Disposition Burial Cremation Other Disposition Custom InstructionsSpouse's Healthcare Power of AttorneyA Healthcare Power of Attorney empowers you to appoint an agent to handle your healthcare should you ever need someone to step in and assist. A Healthcare Power of Attorney also serves to prevent s Guardianship by the court by proactively appointing an individual of your choosing. A healthcare power of attorney is automatically Springing and the Agent only has powers if the Principal is unable to make their own healthcare decisions.Include Spouse's Healthcare Power of Attorney?(Required) Yes No Spouse's Primary Healthcare Agent First Middle Last Suffix This is your first choice to handle your financial and legal affairs if you are in a position where you may need someone to step in and assist.Spouse's Successor Healthcare Agent First Middle Last Suffix This is your second choice to handle your financial and legal affairs if you are in a position where you may need someone to step in and assist.Spouse's Disposition of the BodyA Healthcare Power of Attorney allows you to choose burial or cremation. What would be your choice when the time comes? Burial Cremation Other Prepare Spouse HCPOA? Yes No Spouse Disposition Burial Cremation Other Spouse Disposition Custom Instructions This field is hidden when viewing the formLiving Will / Declaration for Natural DeathYour Living Will / Declaration for Natural DeathA declaration for a desire for a natural death or Living Will allows your voice to be heard in a situation where you are terminal, incurable, in a persistent vegetative state, and the only medical procedures that can be done will prolong your suffering.Would you like to include a Living Will? Yes No Medical Preferences No Life-Prolonging Measures Artificial Nutrition and Hydration Prepare Living Will? Yes No Living Will Type Standard Living Will Catholic Living Will Living Will NotesSpouse’s Living WillA declaration for a desire for a natural death or Living Will allows your voice to be heard in a situation where you are terminal, incurable, in a persistent vegetative state, and the only medical procedures that can be done will prolong your suffering.Include Spouse's Living Will? Yes No Medical Preferences No Life-Prolonging Measures Artificial Nutrition and Hydration Prepare Spouse Living Will? Yes No Spouse Living Will Type Standard Living Will Catholic Living Will Spouse Living Will Notes This field is hidden when viewing the formLast Will and TestamentYour Last Will and TestamentWould you like to include your Last Will & Testament? Yes No Executor Name First Middle Last Suffix Your Executor will be in charge of following the instructions within your will and distributing assets under the watchful eye of the court.Alternate Executor Name First Middle Last Suffix In the event that your primary executor cannot perform their duties the alternate would step in and become the primary executor.Heirs and Distribution PercentagesHeir NameRelationshipPercentage % Add RemoveDo you have specific distributions or items to list? Yes No Specific Distributions or ItemsShall executor sell real estate and distribute proceeds? Yes No Prepare Last Will & Testament Yes No Are any Heirs Disabled? Yes No List Disabled HeirsSpecific Distributions Use Client’s Choices Attorney Custom Choices Explain Attorney Custom ChoicesResiduary EstateSub-Trusts Needed? Supplemental Needs Sub-Trust Sub-Trust for Underage Children/Grandchildren Underage Sub-Trust Distribution 20&5 Distribution (20% over 5 yrs starting at age 25) 10&10 Distribution (10% over 10 yrs starting at age 25) 5&20 Distribution (5% over 20 yrs starting at age 25) Other Spouse's Last Will and TestamentWould you like to include spouse's Last Will & Testament? Yes No Executor Name First Middle Last Suffix Your Executor will be in charge of following the instructions within your will and distributing assets under the watchful eye of the court.Alternate Executor Name First Middle Last Suffix In the event that your primary executor cannot perform their duties the alternate would step in and become the primary executor.This field is hidden when viewing the formWhich previously listed individuals should inherit under spouse's Will? All Children from Current Marriage All Your Children from Previous Relationships All Spouse’s Children from Previous Relationships All Other Heirs Previously Listed Specify Additional Heirs This field is hidden when viewing the formSpecify Additional Heirs (Spouses's Will) Add Remove TrustsWould you like to include a Trust? Yes No Trust Name[Guidance for naming a trust]Trustee Name First Middle Last Suffix [Guidance for naming a trustee]Successor Trustee Name First Middle Last Suffix [Guidance for naming a successor trustee]Trust Beneficiaries and DistributionBeneficiary NameRelationshipPercentage % Add RemoveTransfer Real Estate into the Trust? Yes No Properties to Transfer into Trust Add RemoveAdd the address of each property to transfer into trust.Would you like to include a spouse Trust as well? Yes No Trustee Name First Middle Last Suffix [Guidance for naming a trustee]Prepare Trust? Yes No Trust Type Revocable Living Trust (RLT) Irrevocable Trust (MAPT) Convertible Trust Convertible Trust Options Convertible upon One Grantor Incapacity Convertible upon Both Grantors Incapacitated Survivor Trust Convertibility Trigger Prepare Pour-Over Will? Yes No Prepare Assignment of Personal Property? Yes No Prepare Certification of Trust? Yes No Are any heirs disabled? Yes No Disabled Heirs NamesTrust Distributions Use Client’s Choices Attorney Custom Choices Explain Attorney Custom ChoicesResiduary Estate InstructionsSub-Trusts Needed in Main Trust? IRA Conduit Sub-Trust Supplemental Needs Sub-Trust Sub-Trust for Underage Children/Grandchildren Underage Sub-Trust Distributions 20&5 Distribution (20% over 5 yrs starting at age 25) 10&10 Distribution (10% over 10 yrs starting at age 25) 5&20 Distribution (5% over 20 yrs starting at age 25) Other Add Additional Custom Sub-Trusts Add Additional Custom Sub-Trusts Additional Custom Sub-Trusts Ladybird DeedWould you like to include a Ladybird Deed? Yes No Ladybird Deed PropertiesProperty AddressBeneficiary Add RemoveInclude Ladybird Deed? Yes No Attorney Additional Instructions This field is hidden when viewing the formFinal Review & SubmissionDo you have any questions or additional information to provide?Final Review Completed & Documents Ready for Drafting? Yes Other Final Notes or Special InstructionsFacebookThis field is for validation purposes and should be left unchanged.
