Page title

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Trust Name: The ___________________ Trust

Client Information - Strictly Confidential

Spouse/Partner #1:

First Name

Middle Name

Last Name

Aliases Used

Phone Number

Birth Date

Gender

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Spouse/Partner #2:

First Name

Middle Name

Last Name

Aliases Used

Phone Number

Birth Date

Gender

IF NOT, please indicate how you would like them to be referenced throughout the trust:

(e.g., "Significant Other", "Partner", "Life Partner", "Friend", etc.)

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Address:

Street Address 1

Apartment/Suite Number

City

County

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Current Assets

Please check all that apply and provide the requested details
for the assets you want this specific trust to hold.

Bank Accounts / Safety Deposit Box

Bank Account/Safety Deposit Box Details

Please include:
- Bank or Institution
- Name on the Account
- Type of Account

Retirement Accounts

Retirement Accounts Details

Please include:
- Bank or Institution
- What kind of account it is (401K, IRA, etc.)
- Name on the account

Real Property

Real Property Details

Please include:
- Property Address
- Indicate if its personal/investment property

Business Entities

Business Entities Details

Please Include:
- Name of Business
- Purpose of Business

Stocks and Bonds

Stocks and Bonds Details

Insurance/Annuities

Insurance/Annuities Details

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Trust Information

1. Who would you like to assign as your Trustees?

Management Trustee: The person who will be responsible for managing the assets within the trust. Generally the same as the Grantor of the trust. You can assign co-trustees.

Distribution Trustee: The person who will be responsible for approving and making any distributions out of the trust, and who will NOT benefit from the trust in anyway.

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*If you are assigning co-trustees, please separate names with a comma.

Management Trustee(s)

Please enter the full name(s) of the individual you wish to assign. At least one person is required.

Distribution Trustee(s)

Please enter the full name(s) of the individual you wish to assign. At least one person is required.

2. In the event the Management and/or Distribution Trustees ceases to act as the assigned Trustee, who would you like to be assigned as the Successor Trustees.

Successor Trustee(s): The person who will be responsible for the role of either Distribution or Management Trustee in the event the above assigned Trustee's cease to act as assigned.

*As a reminder, the Distribution Successor Trustee CANNOT be someone who will benefit from the trust in any way.

Successor Management Trustee(s)

Please enter the full name(s) of the individual(s) you wish to assign.

Successor Distribution Trustee(s)

Please enter the full name(s) of the individual(s) you wish to assign.

Beneficiaries

1. Who are your Beneficiaries?

Please enter the full name(s) of any assigned Beneficiaries

Beneficiary 1: Full Name

Beneficiary 2: Full Name

Beneficiary 3: Full Name

Beneficiary 4: Full Name

Beneficiary 5: Full Name

Beneficiary 6: Full Name

Beneficiary 7: Full Name

Beneficiary 8: Full Name

Beneficiary 9: Full Name

Beneficiary 10: Full Name

2. In the event the assigned beneficiaries pass with or before you, please list any contingent beneficiaries you may wish to assign.

Please enter the full name(s) of any assigned Contingent Beneficiary

Contingent Beneficiary 1: Full Name

Contingent Beneficiary 2: Full Name

Contingent Beneficiary 3: Full Name

Contingent Beneficiary 4: Full Name

Contingent Beneficiary 5: Full Name

Contingent Beneficiary 6: Full Name

Contingent Beneficiary 7: Full Name

Contingent Beneficiary 8: Full Name

Contingent Beneficiary 9: Full Name

Contingent Beneficiary 10: Full Name

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WAIVER OF POTENTIAL CONFLICT OF INTEREST

We have each read the foregoing material and understand that there are potential conflicts of interest between myself and my spouse in the matters about which we are consulting you. If either of us desire to have separate counsel or desire you not to be involved at all, that spouse shall notify you. We each hereby consent to having you represent both of us in the drafting of our estate planning documents and we each hereby waive any potential or actual conflicts of interest. We understand that since you will be representing both of us on the same matter, as between ourselves and you, there are no confidential communications.

Dated this Day:

We have read and understand the information regarding the Waiver of Potential Conflict of Interest

Online Signature: Spouse/Partner #1 - (Please type your name below)

Online Signature: Spouse/Partner #2 - (Please type your name below)

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Veil DAPT

Domestic Asset Protection Trust
Worksheet

Please check all that apply and provide the requested details
for the assets you want this specific trust to hold.

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Please check all that apply and provide the requested detailsfor the assets you want this specific trust to hold.

Veil DAPT

Please check all that apply and provide the requested details
for the assets you want this specific trust to hold.