ESTATE PLANNING CONSULTATION QUESTIONS TO BE ANSWERED IN PREPARATION FOR WILL OR TRUST CONSULTATIONThis does not obligate you in any way. All information provided is confidential. It cannot be shared even in the event you decide not to work with us later.Date MM slash DD slash YYYY How did you hear about us? *(Required)How did you hear about Steele Law Firm?An Email I ReceivedBlog / FacebookInternet / Search EngineLanding Pages – Estate PlanningRadio and TVLink from another web siteMailing / PostcardNewsletterNewspaperOtherReferralBiographical Information: First Name(Required) Middle Name Last Name(Required) Any Previous/Other Names (Maiden, earlier marriage, etc.): Physical Address 1 Physical Address 2 Physical address state/province(Required) 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 State Zip *(Required) County *(Required) Email Phone *(Required)Please number (#) in order of preference for us to call you. Also tell us if you prefer we NOT call you at any listed numbers or if you prefer we NOT leave messages at any number due to lack of privacy, etc.Home PreferncepreferencePlease enter a number from 1 to 4.Cell PreferencepreferencePlease enter a number from 1 to 4.Work PreferencepreferencePlease enter a number from 1 to 4.Other PreferencepreferencePlease enter a number from 1 to 4.Alternate Contact PersonAlternate Name Alternate PhoneBest Method to Contact You Your Date of Birth MM slash DD slash YYYY U.S. Citizen? Yes No Resident alien? Yes No Non-Resident alien? Yes No If not a U.S. Citizen, please state citizenship: Employer Title Spouse/Partner:Spouse First Name Spouse Middle Name Spouse Last Name Any Previous/Other Names (Maiden, earlier marriage, etc.): Spouse PhoneIs this? Cell Work Other Spouse Email Date of Birth MM slash DD slash YYYY Spouse U.S. Citizen? Yes No Resident alien? Yes No Non-Resident Alien? Yes No If not a U.S. Citizen, please state citizenship: Employer Title Child(ren)’s Information:Child First Name Spouse Middle Name Child Last Name Child Date of Birth MM slash DD slash YYYY Child Address Child Zip Cell PhoneHome PhoneChild ofChild ofBothHusbandWifeAdopted Yes No Child First Name Spouse Middle Name Child Last Name Child Date of Birth MM slash DD slash YYYY Child Address Child Zip Cell PhoneHome PhoneChild ofChild ofBothHusbandWifeAdopted Yes No Child First Name Child Last Name Spouse Middle Name Child Date of Birth MM slash DD slash YYYY Child Address Child Zip Cell PhoneHome PhoneChild ofChild ofBothHusbandWifeAdopted Yes No Full Names of Children who have predeceased you: Predeceased Child Name Disinherit Their Descendants: Yes No Predeceased Child Name Disinherit Their Descendants: Yes No General Provisions: (These can be the same person for both spouses or each person may select someone different. You only need to provide their address and Phone number once on the form.) Who would you trust to manage your FINANCIAL affairs if you were ILL? YouFirst person PhoneFirst Person Address First Person Email First person PhoneFirst Person Address First Person Email Third person PhoneFirst Person Address First Person Email SPOUSE/PARTNERPerson PhoneFirst Person Address First Person Email Person PhoneFirst Person Address First Person Email Person PhoneFirst Person Address First Person Email Who would you trust to make MEDICAL decisions on your behalf, if you were ILL? YouPerson PhoneFirst Person Address First Person Email Person PhoneFirst Person Address First Person Email Untitled PhoneAddress Email SPOUSE/PARTNERPerson Name PhoneEmail Address Person Name PhoneAddress Email Person Name PhoneAddress Email Who would you trust to manage your FINANCIAL affairs at the TIME OF YOUR DEATH?YouPerson Name PhoneAddress Email Person Name PhoneAddress Email Person Name PhoneAddress Email SPOUSE/PARTNERPerson Name PhoneAddress Email Person Name PhoneAddress Email Person Name PhoneAddress Email If You Have Minor Children: Who would you want your children to live with if you were to pass away?Guardians for Child Child NameRelationship Add RemoveGuardians for Child Child NameRelationship Add RemoveWho would be your heirs and what share of the estate would each receive?If you are married, do you want your spouse to inherit first, before those listed below? Yes No Beneficiary NameWhat should they receive? Add RemoveIf all of your beneficiaries and descendants predecease you, how would you like your estate to be divided? (Note: This is sometimes called a “nuclear provision” because it is often explained in the following way – If everyone you named to inherit was to die in a nuclear accident, then who would you want your estate to go to and how would you want it divided?)Remainder by Intestate Succession:If you are married, do you want your spouse to inherit first, before those listed below? Remainder by Intestate Succession: If at any time there is no beneficiary entitled to receive all or any part of your Trust Estate, all of the remaining portion of your Trust Estate shall then be distributed, outright and free of trust, to those persons who would be your heirs at law. Your “heirs at law” would be your closest blood relative who is alive at that time. Specific Beneficiaries: Like a church/charity, organization or individual not already named NamePercentage % Add RemoveMy estate has the following assets:My estate has the following assets: Real Estate IRAs/Retirement Plans Business/Partnership Stocks/Bonds Life Insurance Certificates of Deposit Bank Accounts Virtual Assets (e.g., cryptocurrency & NFTs) Intellectual Property (e.g., patents, literary) Other Other Approximate gross value of my entire estate: Are you ready to get started on your estate plan? Yes, I am ready to get started on my estate plan. No, I just have some questions. Other questions/concerns: Other questions/concerns: *Please Note: This meeting will be up to 60 minutes. All decision-makers must be present (or we will need to reschedule).*What Really Matters to MePlease rate the following estate planning goals and concerns on a scale of 1 to 10. (1 being “not important at all” and 10 being “very important.”)Make sure there’s a written plan to handle my affairsPlease enter a number from 1 to 10.I want to avoid Living Probate and/or Death ProbatePlease enter a number from 1 to 10.Make sure Nursing Home costs don’t use up all my assetsPlease enter a number from 1 to 10.Make sure my wishes are honored regarding life support decisionsPlease enter a number from 1 to 10.I want to minimize all Death TaxesPlease enter a number from 1 to 10.After my death, make sure my estate stays with my children if they get divorcedPlease enter a number from 1 to 10.Protect my life insurance from Death TaxesPlease enter a number from 1 to 10.Protect my estate if my spouse gets remarried after my deathPlease enter a number from 1 to 10.After my death, protect my estate from my children’s creditorsPlease enter a number from 1 to 10.Protecting my special needs child after my deathPlease enter a number from 1 to 10.Funeral planning for my final arrangements and to make it easier for my familyPlease enter a number from 1 to 10.Permission to Contact I authorize the law firm to occasionally mail or email information to me. I understand that I can unsubscribe to communication from the firm at any time and I also understand that the law firm will not share or sell my contact information to anyone. I prefer to be contacted at the email address listed above.Signature Reset signature Signature locked. Reset to sign again What Really Matters to Me – Spouse/PartnerPlease rate the following estate planning goals and concerns on a scale of 1 to 10. (1 being “not important at all” and 10 being “very important.”)Make sure there’s a written plan to handle my affairsPlease enter a number from 1 to 10.I want to avoid Living Probate and/or Death ProbatePlease enter a number from 1 to 10.Make sure Nursing Home costs don’t use up all my assetsPlease enter a number from 1 to 10.Make sure my wishes are honored regarding life support decisionsPlease enter a number from 1 to 10.I want to minimize all Death TaxesPlease enter a number from 1 to 10.After my death, make sure my estate stays with my children if they get divorcedPlease enter a number from 1 to 10.Protect my life insurance from Death TaxesPlease enter a number from 1 to 10.Protect my estate if my spouse gets remarried after my deathPlease enter a number from 1 to 10.After my death, protect my estate from my children’s creditorsPlease enter a number from 1 to 10.Protecting my special needs child after my deathPlease enter a number from 1 to 10.Funeral planning for my final arrangements and to make it easier for my familyPlease enter a number from 1 to 10.Permission to Contact I authorize the law firm to occasionally mail or email information to me. I understand that I can unsubscribe to communication from the firm at any time and I also understand that the law firm will not share or sell my contact information to anyone. I prefer to be contacted at the email address listed above.Signature Reset signature Signature locked. Reset to sign again Δ
