Estate Plan Review Form Status* Married Single First Name* Last Name* Citizenship* U.S. Citizen* Yes No Spouse/Partner’s First Name Spouse/Partner’s Last Name Spouse’s Email Address Citizenship U.S. Citizen* Yes No Mailing address line 1 Mailing address line 2 Physical address city* Physical address state/province* State *AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State Physical address zip/postal code* Phone 1 number*Office Phone:Phone 2 numberEmail Address* What is the net value of all of your assets?*Do you wish to change your Trustees, Executors or Financial Agents? Yes No Do you wish to change your Health Care Agents? Yes No Do you wish to change your Beneficiaries or their share? (who inherits from you/how much)? Yes No Are all your real property, bank accounts , brokerage accounts, etc. in your Trust? Yes No Has anything major changed since the creation of your trust? (Citizenship change, death, marriage, beneficiary developed substance abuse or financial problems, other?) Yes No Message
