Will Intake Form

Please complete this form before you meet with your attorney to discuss your will preparation. All information requested is relevant, confidential and important. The execution of a Will is a private and personal matter. If you have relatives with you at the execution of the Will, they will be asked to step out of the room to assure the attorney that there is no undue pressure and that the execution is your free act and deed. Thank you!

Will is for:
Your Name(Required)

First Middle Last (Maiden Name)
Today's Date
Social Security Number:
Date of Birth:
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Email(Required)
Have you made a previous will?
Do you have a Power of Attorney?
Do you have a Health Care Proxy?
Have you filed a Homestead exemption?
If yes, what is the property address?
Marital Status:
Date of Marriage:
Spouse Name:
First Last
Spouse Date of Birth:
Spouse Social Security Number:
Do you have children?
First and last names of children and date of birth of each:
Are any of your children of a previous marriage?
I wish to appoint the following guardian of my minor children to age
Please enter a number from 0 to 30.
Name of Guardian:
First Last
Address of Guardian:
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Relationship to you:
If unable to serve or predeceases me, I nominate as contingent:
First Last
Address of contingent:
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Relationship to you:
I wish to appoint as Executor (trix) to carry out the terms of my Will:
First Last
Address of Executor(trix):
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Relationship to you:
My second choice as Executor(trix) is:
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Relationship to you:
The beneficiary of my Will is:
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Relationship to you:
Second beneficiary:
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Relationship to you:
Third Beneficiary:
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Relationship to you:
Name of any person who would normally be listed but are being passed over:
First Last
Name of any additional person:
First Last
Name of any additional person:
First Last