Instructions. By filling out this form as completely as you can, you will help assure that the information is complete and accurate when you meet with the attorney. Thank you.
Fill out only what applies to you. When finished, click on "submit" at the end of this document. If you prefer, you can download the PDF, fill it out online, and then print it.
Home address: Home phone:
City: State: Zip:
Client 1
Client 2
Full name: *
How do you want your name to appear in the documents?
Name(s) used in past:
Work telephone:
Cell phone:
E-mail address:
Occupation:
Birth date:
U.S. citizen?
YesNo
Wedding anniversary date:
Prior marriages?
Former spouse No. 1 name:
Ended by spouse No. 1: DeathDivorceAnnulmentNo
DeathDivorceAnnulmentNo
Year death/divorce spouse No. 1:
Former spouse No. 2 name:
Ended by spouse No. 2: DeathDivorceAnnulmentNo
Year death/divorce spouse No. 2:
Are you named as trustee or executor?
YESNO
Whose trust or will?
Are you named as agent under a power of attorney?
Whose power of attorney?
Do you have health concerns?
Please explain:
Are you scheduled for an surgery?
When?
Are you going on vacation soon?
1. Who may we thank for referring you to this office?
2. Do you have any specific bequests you wish to make?
Person/Organization
Amount or Asset
When To Be Given
3. Have you made any gifts of $10,000 or more in any one year to any one person?
If Yes, please explain:
4. Do you wish to specifically disinherit an individual or group of people?
If Yes, who?
5. Do you have some specific questions or concerns you would like to discuss? If yes, please note them here:
Please note that children of your present marriage are listed first. Children of prior marriage(s), whether of yourself or your spouse, are listed separately. Please write in the "other information" space any other helpful information you would like the attorney to know such as if the child is adopted or has special needs because of developmental, physical or mental disability.
1. Full name: Spouse:
Address:
Home phone: Office: Cell:
Date of birth: Email: Gender:
MaleFemale
Child No. 1: D.O.B.
Child No. 2: D.O.B.
Child No. 3: D.O.B.
Child No. 4: D.O.B.
Other helpful information:
2. Full name: Spouse:
3. Full name: Spouse:
Date of birth: Email Gender:
Full name: Spouse:
Home phone: ] Office: Cell:
Father: Mother:
Are there other important people in the lives of you and your spouse, such as a person dependent upon you for support, or a person whom you raised as a child but is not legally your child? (Note: an adopted child is legally your child and should be listed above.) If so, please list.
Relationship to you:
Do you now or might you in the future provide financial support?
If yes, monthly amount:
Are you now, or might you in the future, provide financial support?
If you have executed any of the following documents, please provide your attorney with a copy if possible. If you cannot readily locate them, please be prepared to discuss their contents.
Copy Available?
Personal Documents:
Divorce Decree
Premarital Agreement
Community Property Agreement
Marital Property Agreement
Existing Estate Planning Documents:
Will
Trust
Power of Attorney For Asset Management
Power of Attorney for Health Care
Living Will or Directive to Physician
Other Documents:
Funeral and Burial Arrangements
Cemetery Plot
Organ Donation Directive
Financial Institution:
Branch:
Telephone No.: Box No.:
Who are signatories?
Lawyer:
Name:
Firm:
Telephone No.: E-mail address:
Purpose of representation:
Okay for attorney to contact? YesNo
Accountant:
Stockbrokers/Investment Advisor:
Life Insurance Agent:
Yes, I'd like to receive valuable information from the team at Johnston & Associates.
Johnston & Associates
