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  • Home
  • Annuities
      • What is an Annuity?
      • Fixed Annuities
      • Fixed Indexed Annuities
      • CD Annuities
      • Income Rider
      • Income Calculator
  • Insurance
      • Term Life Insurance
      • Indexed
      • Universal Life Insurance
      • Long-Term Care
      • Life Insurance with Long Term Care Rider
  • Estate Planning
      • Revocable Living Trusts
      • Irrevocable Trusts
      • Special Needs Trusts
      • Life Insurance Trusts
      • Trust Amendments
      • Trust Restatements
      • Wills
      • Codicils
      • Deeds (Property Transfer)
      • Beneficiary Deeds
      • Financial Power of Attorney
      • Advanced Health Care Directives
      • Mental Health Care Power of Attorney
      • Estate Settlement
  • Tax Planning
  • Tools
    • Useful Links
    • Tax Resources
    • Glossary
    • Calculators
    • Client Intake Form
  • The Retiretastic Show

Client Intake Form

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  • Most clients prefer either: The Jones Family or The John and Mary Jones Living Trust.
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  • Section A: Client Personal Information






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  • Section B: Children or Beneficiaries

    Parent Codes
    B = Natural Child of Both Spouses | 1 = Natural Child of Client 1 | 2 = Natural Child of Client 2
    A1 = Adopted by Client 1 | A2 = Adopted by Client 2 | DC = Deceased with Children | DN = Deceased with No Children
    • Check All That Apply





    • Check All That Apply





    • Check All That Apply





    • Check All That Apply
  • Are any of your children or named beneficiaries handicapped or do they receive SSI benefits?
  • If a beneficiary predeceases their distribution of the estate, distribute as follows:
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  • Section C: Trustee(S)

  • Client 1 to serve as Original Trustee
  • Successor Trustee(s) & Executors for Four - Over Will
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  • Section D: Durable Power of Attourney for Asset Management

  • Power of Attorney(s) for Client 1





        • Power of Attorney(s) for Client 2
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              • Section E: Durable Power of Attorney for Health Care

              • Power of Attorney(s) for Client 1





              • Power of Attorney(s) for Client 2
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              • ACKNOWLEDGMENT: I/We have read the information on this application and confirm that it is true and correct.
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              Sun City Office

              10001 West Bell Road
              Suite 148
              Sun City, AZ 85351

              Phone: 623-561-2323

              Las Vegas Office

              9550 South Eastern Ave.
              Suite 253
              Las Vegas, NV 89123

              Phone: 702-835-6190

              Corporate Mailing Address

              20280 North 59th Avenue
              Suite 115-321
              Glendale, AZ 85308

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