Legacy Wealth Planning Consultation Form

My estate has the following assets:

Bank AccountBusiness/PartnershipsCertificates of DepositFundsIRA/Retirement PlansLife InsuranceReal EstateStocks, Bonds, Mutual

Please check one of the following boxes:

I am ready to proceed with the creation of my plan.My loved one is already in a nursing home, I am ready to proceed with a plan.I am not interested in creating a plan at this time. I’m here for general information only.I need the following questions answered before I am ready to proceed with the creation of my plan:

What Really Matters to Me

Please rate the following estate planning goals and concerns on a scale of 1 to 10. (1 being “not important at all” and 10 being “very important.”)

Make sure there's a written plan to handle my affairs

I want to avoid Living Probate and/or Death Probate

Make sure Nursing Home costs don’t use up all my assets

Make sure my wishes are honored regarding life support decisions

I want to minimize all Death Taxes

After my death, make sure my estate stays with my children if they get divorced

Protect my life insurance from Death Taxes

Protect my estate if my spouse gets remarried after my death

After my death, protect my estate from my children’s creditors

Protecting my special needs child after my death

Funeral planning for my final arrangements and to make it easier for my family

Permission to Contact

I authorize the law firm to occasionally mail, fax or email information to me. I understand that I can unsubscribe to communication from the firm at any time and I also understand that the law firm will not share or sell my contact information to anyone. I prefer to be contacted at the email address listed above.

What Really Matters to Me

Permission to Contact

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Interested in learning more or have some questions?