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Estate Planning Intake Form

Client Name

Email

Family Facts

Name:

Home Address:

City, State, Zip:

Country:

Home Phone:

Cell:

SSN:

Date of Birth:

Citizenship:

Annual Income:

Spouse/Partner Name:

Home Address:

City, State, Zip:

Country:

Home Phone:

Cell:

SSN:

Date of Birth

Citizenship:

Annual Income:

Marriage Information

Date of Marriage:

Have you and your spouse signed a premarital agreement?

Yes

No

If Yes, please upload a copy of that agreement

Have you or your spouse been divorced?

Yes

No

If Yes, please upload a copy of the divorce decree(s).

Have you ever lived in a community Property State?

Yes

No

If Yes, please select the states that you have lived

Wisconsin

Arizona

California

Texas

New Mexico

Washington

Louisiana

Nevada

Idaho

Children

Please list ALL children, including deceased children and children born out of wedlock.

Please identify any child who is not a natural or adopted child of both you and your spouse

Name of child:

Address:

City, State, Zip:

Phone No.(s):

Date of Birth:

Name of child:

Address:

City, State, Zip:

Phone No.(s):

Date of Birth:

Name of child:

Address:

City, State, Zip:

Phone No.(s):

Date of Birth:

Name of child:

Address:

City, State, Zip:

Phone No.(s):

Date of Birth:

Name of child:

Address:

City, State, Zip:

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