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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
Search for:
Will Application
Step
1
of
13
7%
Section A:
Client Personal Information
Client 1
Name
*
Date of Birth
*
Email
*
Marital Status
*
Married
Divorced
Widowed
Previously Divorced
Citizenship
*
US
Other
Client 1 Citizenship Other
Home Phone #
*
Work Phone #
Address
*
Street Address
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
County
*
Client 2
Name
Date of Birth
Email
Marital Status
Married
Divorced
Widowed
Previously Divorced
Citizenship
US
Other
Client 2 Citizenship Other
Section B:
Children
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
Child 1
Full Name
Percentage of Estate
Date of Birth
Parent Code
Check All That Apply
B
1
2
A1
A2
DC
DN
Child 2
Full Name
Percentage of Estate
Date of Birth
Parent Code
Check All That Apply
B
1
2
A1
A2
DC
DN
Child 3
Full Name
Percentage of Estate
Date of Birth
Parent Code
Check All That Apply
B
1
2
A1
A2
DC
DN
Child 4
Full Name
Percentage of Estate
Date of Birth
Parent Code
Check All That Apply
B
1
2
A1
A2
DC
DN
Child 5
Full Name
Percentage of Estate
Date of Birth
Parent Code
Check All That Apply
B
1
2
A1
A2
DC
DN
Child 6
Full Name
Percentage of Estate
Date of Birth
Parent Code
Check All That Apply
B
1
2
A1
A2
DC
DN
Child 7
Full Name
Percentage of Estate
Date of Birth
Parent Code
Check All That Apply
B
1
2
A1
A2
DC
DN
Child 8
Full Name
Percentage of Estate
Date of Birth
Parent Code
Check All That Apply
B
1
2
A1
A2
DC
DN
Child 9
Full Name
Percentage of Estate
Date of Birth
Parent Code
Check All That Apply
B
1
2
A1
A2
DC
DN
Handicapped?
Are any of your children or named beneficiaries handicapped or do they receive SSI benefits?
Yes
No
Section C:
Additional Beneficiaries
Please list full names.
Name
Percent of Estate
Name
Percent of Estate
Name
Percent of Estate
Name
Percent of Estate
Section D:
Contingent Beneficiaries
Contingent Beneficiaries
In the event a named beneficiary pre-deceases the distribution of his/her share of my/our estate, I/we want that individual’s share distributed as follows:
Equally among surviving beneficiaries
Spouse of the deceased beneficiary
Per stirpes
Per stirpes, then to/ratably among surviving beneficiary(ies)
Other
Spouse of the Deceased Beneficiary Name
Other Contingent Beneficiaries
Section E:
Executors for Will
Exec for Will Server
*
Spouse to serve as
Sole Primary Executor
Alternate Executors to
serve in order listed
Alternate Executors to
serve together
Executors for Client 1
Exec For Client 1 Spouse
Spouse or:
Name
Phone
Name
Phone
Name
Phone
Executors for Client 2
Exec For Client 2 Spouse
Spouse or:
Name
Phone
Name
Phone
Name
Phone
Section F:
Durable Power of Attorney for Asset Management
In the event you become incapacitated, the person(s) you have chosen as Power of Attorney, or “Attorney in Fact,” is to act on your behalf in managing your assets that have not been put into your trust. Your spouse would ordinarily be named as Primary Agent.
The Agent(s) named
*
The Agent(s) named are to serve in order listed
The Agent(s) named are to serve together (jointly)
Power of Attorney for Client 1:
Durable POA Assets Client 1 Spouse
Spouse or:
Name
I or IC
I
IC
Name
I or IC
I
IC
Name
I or IC
I
IC
Power of Attorney for Client 2:
Durable POA Assets Client 2 Spouse
Spouse or:
Name
I or IC
I
IC
Name
I or IC
I
IC
Name
I or IC
I
IC
Section G:
Durable Power of Attorney for Health Care
In the event you become incapacitated, the person(s) you have chosen as Power of Attorney, or “Attorney in Fact,” is to act on your behalf in making health care decisions for you. Your spouse would ordinarily be named as Primary Agent.
The Agent(s) named
*
The Agent(s) named are to serve in order listed
The Agent(s) named are to serve together (jointly)
Power of Attorney for Client 1:
Durable POA Health Client 1 Spouse
Spouse or:
Name
Phone
Name
Phone
Name
Phone
Remains
Cremation
Burial
Power of Attorney for Client 2:
Spouse
Spouse or:
Name
Phone
Name
Phone
Name
Phone
Remains
Cremation
Burial
Section H:
Guardian for Minor or Handicapped Children
If you are the parent or legal guardian of a minor child or other individual, list your choice for Guardian should both you and your spouse die or become incapacitated.
Name of Child/Individual
Guardian Appointee
First Alternate
Name of Child/Individual
Guardian Appointee
First Alternate
Section I:
Value of Your Estate
Please indicate the approximate value of your estate (include real estate, savings, investments, personal property and collectibles).
Value
*
Less than $400,000
Between $400,001 and $999,999
Greater than $1,000,000
Section J:
Real Estate
Total number of in-state beneficiary deeds to be transferred and recorded:
Number
*
List of Properties (Attach list if more than 2)
Physical Address (Property 1)
Enter Street Address Unit # City State and Zip Code.
County
APN#
Value
Physical Address (Property 2)
Enter Street Address Unit # City State and Zip Code.
County
APN#
Value
Section K:
Special Instructions
Untitled
Section L:
Previous Will Instructions
Untitled
Are there any special provisions or information in your old document that need to be included in your new document? (Attach Copy)
ACKNOWLEDGMENT:
I/We have read the information on this application and confirm that it is true and correct.
Client 1 Signature
*
Reset signature
Signature locked. Reset to sign again
Date
*
Client 2 Signature
Reset signature
Signature locked. Reset to sign again
Date
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Comments
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