Estate Planning Docs Generation Step 1 of 6 16% Basic InformationToday's Date(Required) MM slash DD slash YYYY Your Full Name First Your Email(Required) What is your street address?What city do you reside in?What county do you reside in?What state do you reside in?What is your zip code? FamilyAre you married?(Required) Yes No Your Spouse’s NameDo you have child(ren)?(Required) Yes No Number of child(ren)Please provide the full name for each of your children:Add one row per child. Add Remove Gifts and BeneficiariesDo you want to leave a specific item, amount of money, or piece of property to someone? If yes, describe it:Name the person who should receive this gift:If the above named person passes away before you, who should get this gift instead?Who should receive the rest of your estate (everything else you own)? (Enter full name(s))If that person has already passed away, who should receive instead?If the two groups of people or persons named above have already passed away, who should receive instead?If the above named person(s) passes away, who should receive instead?If the above named person(s) passes away, who should receive instead?Name anyone that you want to specifically leave out of your will:This field is hidden when viewing the formDo you want to list “backup” recipients?(Required) Yes No If anything is left over, who should receive it? (This is your “backup” person/people):Fiduciary AppointmentsName of the person you trust to manage money/property for a minor or disabled beneficiary:If that person cannot serve, who should serve instead?If that person also cannot serve, who should serve instead?This field is hidden when viewing the formIf your spouse does not survive you Yes No If you have minor children, who should be their legal guardian if you pass away?If that person cannot serve, who should serve instead?Who do you want to be your Executor (the person who carries out your Will)?Do you want the Executor to be compensated for their services? Yes No If that person cannot serve, who should serve instead?If that person also cannot serve, who should serve instead?Who is your primary attorney?(Required) Chavon Carr Gere Cole Medical Power of AttorneyFull name of the person you want to make your health care decisions if you cannotRelation with the person you want to make your health care decisions if you cannotAddress of the person you want to make your health care decisions if you cannotPhone Number of the person you want to make your health care decisions if you cannotWhen should this Medical Power of Attorney take effect? This medical power of attorney takes effect if I become unable to make my own health care decisions and this fact is certified in writing by my physician. This medical power of attorney is effective upon execution and is not affected by my subsequent disability or incapacity. If your primary health care agent is unavailable, who should serve (as Alternate Health Care Agent) instead? (Full name)Relation with the Alternate Health Care Agent, If your primary health care agent is unavailableAddress of Alternate Health Care Agent, If your primary health care agent is unavailablePhone Number of Alternate Health Care Agent, If your primary health care agent is unavailableIf your alternate health care agent also unavailable, who should serve (as Second Alternate Health Care Agent) instead? (Full name)Relation with the Second Alternate Health Care Agent, If your alternate health care agent is unavailableAddress of Second Alternate Health Care Agent, If your alternate health care agent is unavailablePhone Number of Second Alternate Health Care Agent, If your alternate health care agent is unavailableThis field is hidden when viewing the formHIPAA Authorization / Medical ReleaseThis field is hidden when viewing the formFull name of the person you want to give access to your medical informationThis field is hidden when viewing the formAddress of the person you want to give access to your medical information (street, city, state, zip)This field is hidden when viewing the formPhone number of the person you want to give access to your medical informationThis field is hidden when viewing the formIf your primary agent is unavailable, who should have access instead? (Full name)This field is hidden when viewing the formAddress of Alternate Medical Release Agent, If your primary agent is unavailableThis field is hidden when viewing the formPhone Number Alternate Medical Release Agent, If your primary agent is unavailableThis field is hidden when viewing the formWitnessesThis field is hidden when viewing the formName of Witness 1This field is hidden when viewing the formAddress of Witness 1This field is hidden when viewing the formName of Witness 2This field is hidden when viewing the formAddress of Witness 2This field is hidden when viewing the formDo you have any additional requests about your medical treatment?After discussion with your physician, you may wish to consider listing particular treatments in Addition Requests field (see below) that you do or do not want in specific circumstances, such as artificially administered nutrition and hydration, intravenous antibiotics, etc. Be sure to state whether you do or do not want the particular treatment.) This field is hidden when viewing the formAdult GuardianshipThis field is hidden when viewing the formPrimary guardian of your person (full name)This field is hidden when viewing the formPrimary guardian of your person (relation to you, e.g., “spouse,” “friend”)This field is hidden when viewing the formName of First Alternate Guardian of your personThis field is hidden when viewing the formRelation with First Alternate Guardian of your personThis field is hidden when viewing the formName of Second Alternate Guardian of your personThis field is hidden when viewing the formRelation with Second Alternate Guardian of your personThis field is hidden when viewing the formName of Primary Guardian of your EstateThis field is hidden when viewing the formRelation with Primary Guardian of your EstateThis field is hidden when viewing the formName of First Alternate Guardian of your EstateThis field is hidden when viewing the formRelation with First Alternate Guardian of your EstateThis field is hidden when viewing the formName of Second Alternate Guardian of your EstateThis field is hidden when viewing the formRelation of Second Alternate Guardian your EstateMinor Child GuardianshipDo you have minor Daughter(s)? Yes No Number of Daughter(s)Name of Daughter(s) Add RemoveDo you have minor Son(s)? Yes No Number of Son(s)Name of Son(s) Add RemoveFull name of first primary guardian - For Appointment of Guardian for Minor ChildRelation of first primary guardian to child - For Appointment of Guardian for Minor ChildFull name of second primary guardian - For Appointment of Guardian for Minor ChildRelation of second primary guardian to child - For Appointment of Guardian for Minor ChildName the children for which you want to appoint a guardian - For Appointment of Guardian for Minor ChildFull name of first alternate guardian - For Appointment of Guardian for Minor ChildRelation of first alternate guardian to child- For Appointment of Guardian for Minor ChildFull name of second alternate guardian - For Appointment of Guardian for Minor ChildRelation of second alternate guardian to child - For Appointment of Guardian for Minor Child Statutory Durable Power of AttorneyThis field is hidden when viewing the formSelect the Powers that you want to grant to Power of Attorney Real property transactions Tangible personal property transactions Stock and bond transactions Commodity and option transactions Banking and other financial institution transactions Business operating transactions Insurance and annuity transactions Estate, trust, and other beneficiary transactions Claims and litigation Personal and family maintenance Benefits from social security, Medicare, Medicaid, or other governmental programs or civil or military service Retirement plan transactions Tax matters Digital assets and the content of an electronic communication Full name of the person you want to handle your financial matters- For Statutory Durable Power Of AttorneyRelation with the person you want to handle your financial matters- For Statutory Durable Power Of AttorneyAddress of of the person you want to handle your financial matters- For Statutory Durable Power Of AttorneySelect the areas for which you want to give special instructions Gifts Power to Create and Transfer Assets into Trust Disclaimer Compensation When should this Power of Attorney become effective? (Statutory Durable Power Of Attorney)(Required) This power of attorney is not affected by my subsequent disability or incapacity. This power of attorney becomes effective upon my disability or incapacity. Name of alternate Agent 1 - For Statutory Durable Power Of AttorneyRelation with alternate Agent 1 - For Statutory Durable Power Of AttorneyAddress of Alternate Agent 1 - For Statutory Durable Power Of AttorneyName of alternate Agent 2 - For Statutory Durable Power Of AttorneyRelation with alternate Agent 2 - For Statutory Durable Power Of AttorneyAddress of Alternate Agent 2 - For Statutory Durable Power Of AttorneyPlease enter the name of the person and the county s/he belongs to. For example: Joe - Harris CountyName(s) of anyone you want to specifically prevent from being guardian of your estate Add RemoveName(s) of anyone you want to specifically prevent from being guardian of your person Add Remove