Estate Plan Review Form Status*MarriedSingleFirst Name*Last Name*Citizenship*U.S. Citizen*YesNoSpouse/Partner’s First NameSpouse/Partner’s Last NameDate of Birth Date Format: MM slash DD slash YYYY U.S. Citizen*YesNoMailing address line 1Mailing address line 2Physical 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* Spouse’s Email Address What is the net value of all of your assets?*Do you wish to change your Trustees, Executors or Financial Agents?YesNoDo you wish to change your Health Care Agents?YesNoDo you wish to change your Beneficiaries or their share? (who inherits from you/how much)?YesNoAre all your real property, bank accounts , brokerage accounts, etc. in your Trust?YesNoHas anything major changed since the creation of your trust? (Citizenship change, death, marriage, beneficiary developed substance abuse or financial problems, other?)YesNoMessage
