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Client Details:

(enter name as it appears on your driver's license)

Spouse Details:

(enter name as it appears on your driver's license)

Full Name *
Date of Birth
Email
Phone Number
Full Name *
Date of Birth
Email
Phone Number
Address
Address

Beneficiaries (Children)

Estate will be distributed equally between beneficiaries unless a cash gift is specified. Any cash gifts will be deducted from the total before equal distribution to all other beneficiaries.

Full Name *
Full Name *
Date of Birth
Relation
Gender
Date of Birth
Relation
Gender

Successor Trustee/Executor

You and your spouse are each other's initial trustees, guardians, and agents for durable power of attorney. You may nominate your adult children / beneficiaries / foreign residents as successor trustees as long as they are over the age of 18.

Full Name *
Relation
Gender
Phone Number
Address
Successor #2
Full Name *
Relation
Gender
Phone Number
Address

Timing Of Distribution

(Trustee will give allowances to children for expenses prior to final distribution.)

Or distributed at up to 3 equal installments at age:

Guardianship For Minor Children Younger Than 18

Full Name *
Relation to Client
Phone Number
Address

Successor Agent for Medical Decisions

Only fill-in if you want someone different than the Successor Trustee(s)

Full Name *
Relation
Phone Number
Address

Health Care Provisions

Stop life support if in irreversible Coma?

Client
Spouse

Organ Donation

Client
Spouse

Autopsy ok if requested by family member?

Client
Spouse

Burial / Cremation / Agent’s Discretion

Client
Spouse

Rental Properties

Address
Another Rental Property
Address

Previous Marriage

Previous Spouse’s Name (if applicable)

Client
Spouse
Death/Divorce?
Death/Divorce?
Year
Year

Previous Estate Plan

Trust Name
Signing Date

Notes / Comments / Questions

Please add any additional information as needed in the next section. Please include full contact information and relationship to husband for any additional trustees or beneficiaries.

Additional Notes

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Tel: (408) 252-4911

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