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Name of Trust: The ______________ Living Trust

Client Information - Strictly Confidential

*When entering names of individuals, including yourself, please be sure to list their full legal name*

Client:

First Name

Middle Name

Last Name

Aliases Used

Phone Number

Birth Date

Gender

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Address:

Street Address 1

Apt Suite Number

City

Zip Code

County

Home Phone Number

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Prior Marriages

If you answered YES:

Please enter the full name(s) of your previous spouse(s):

Date of Termination

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Children or Beneficiaries

All children must be listed, including children who are disinherited. If additional space is needed, please use the supplemental section at the end.

I DO NOT have any children

(If you check this box, skip this section)

Beneficiary #1

Full Name

Birth Date

Relationship

Relation to Who

Gender

Beneficiary #2

Full Name

Birth Date

Relationship

Relation to Who

Gender

Beneficiary #3

Full Name

Birth Date

Relationship

Relation to Who

Gender

Beneficiary #4

Full Name

Birth Date

Relationship

Relation to Who

Gender

Beneficiary #5

Full Name

Birth Date

Relationship

Relation to Who

Gender

Beneficiary #6

Full Name

Birth Date

Relationship

Relation to Who

Gender

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If you answered YES:

Please enter the full name(s) of each child(ren)

Please enter the full name(s) of each surviving child(ren)

If you answered YES:

Please enter the full name(s) of each child(ren)

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Miscellaneous Information

Do you have any specific concerns (not already mentioned) regarding your estate?

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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 Account/Safety Deposit Box Details

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

Retirement Accounts Details

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

Real Property Details

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

Business Entities Details

Please Include:
- Name of Business
- Purpose of Business

Stocks and Bonds: Details

Insurances/Annuities Details:

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Specific Distributions

IF YES: List the name of the business and beneficiary

IF YES: List preferred age of inheritance

IF YES: Please list the details

IF YES: List the name of the beneficiary

Residual Distributions

In general, how would you like the remaining assets of your estate to be distributed among your beneficiaries after BOTH spouses/partners pass away?

NOTE: Any unspecified assets, typically split into percentages between chosen beneficiaries.

If a beneficiary passes before you/the time of distribution, would you like their share to pass to their children, if any (Per Stirpes) or to the remaining beneficiaries (Per Capita)?

Per Stirpes: Deceased beneficiary's share goes to their children in equal shares. If no children exist, the share will then be distributed to the remaining beneficiaries.

Per Capita: Deceased beneficiary's share is distributed to the remaining beneficiaries.

If ALL beneficiaries were to die at the same time, who would you like to list as a contingent beneficiary? (individual, church, school, organization)

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Trust & Will Information

Each of you will automatically be listed in the trust as the first successor trustee and first successor medical agent for your spouse/partner. Please list who you would like to act, should you both pass away or become incapacitated.

*Individuals MUST be a legal adult (At least 18 years old)

Who would you like to administer your estate after your death?

Successor Trustee: The person who assumes control of the trust after the initial trustee(s) dies or becomes unable to continue with his or her (their) responsibilities. Once the successor trustee has assumed control, he or she is responsible to ensure that your property is distributed to your beneficiaries according to the trust terms.

First Successor Trustee:

First Successor Trustee: Full Name

First Successor Trustee: Relationship

Second Successor Trustee:

Second Successor Trustee: Full Name

Second Successor Trustee: Relationship

Third Successor Trustee:

Third Successor Trustee: Full Name

Third Successor Trustee: Relationship

Only Chose One Option

I would like my Successor Trustees to act in succession, in the order provided.

I would like my Successor Trustees to act together as Co-Trustees.

IF YES: List Amount/Percentage or "general language to be added"

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Who would you like to help administer Medical Decisions if you become incapacitated?

Successor Agent: The person you choose in advance to make health care related decisions on your behalf in the event that you become unable to do so. They may also follow through with your predetermined wishes. Your spouse/partner (if applicable) is generally your first Medical Agent.

*Must be at least 18 years old or older.

First Successor Agent:

Full Name

Relationship

Second Successor Agent:

Full Name

Relationship

Third Successor Agent:

Full Name

Relationship

Guardians

A legal guardian is a person who has the legal authority to care for the personal and property interests of another person. In most cases, minor children. Your spouse/partner if applicable is generally the first Successor Guardian.

*Any individual listed must be a legal adult (at least 18 years old).

First Successor Guardian:

Full Name

Relationship

Second Successor Guardian:

Full Name

Relationship

Third Successor Guardian:

Full Name

Relationship

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Burial Wishes

If you choose to be cremated, where would you like your ashes placed?

If you choose to be buried, where would you like your remains interred?

If YES, please specify:

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Supplementary Section

Please list any additional beneficiaries, concerns, and/or wishes not covered in this form:

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Final Submission

Dated This Day:

The information supplied in this questionnaire is true and correct to best of my knowledge.

Online Signature: (Please type your name below)

Submit

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Veil Estate Plan

Individual 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 Estate Plan

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