Estate Planning Attorneys serving Murray, Mayfield & Western KY

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Estate Planning Form

Family Information

Name

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone Number

Email Address

Spouse- Name

(If applicable)

First Name

Last Name

Spouse's Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

#1 - Child's Name

First Name

Last Name

#2 - Child's - Name

First Name

Last Name

#3 - Child's - Name

First Name

Last Name

Others to be named in Will as beneficiaries:

Beneficiary Name

First Name

Last Name

Beneficiary Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Beneficiary 2 Name

First Name

Last Name

Beneficiary 2 Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Beneficiary 3 Name

First Name

Last Name

Beneficiary 3 Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Part II - Will Instructions

Disposition of household goods, personal effects, jewelry, automobiles etc.:

Executor Name

First Name

Last Name

Cash Gifts to Individuals or Charities

Disposition of Residue (including trust for spouse and/or minors, payment of income from trust, payment of capital from trust, time of distribution, provision should any beneficiaries predecease, etc.):

Special clauses to be included

(a) Appointment of guardians and custodians for children? (b) Guardian Name/Address

Funeral and other special instructions:

Powers of Attorney

Do you wish to have a general financial power of attorney?

Yes

No

Primary Attorney’s Name

First Name

Last Name

Primary Attorney’s Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Alternate Attorney’s Name

First Name

Last Name

Alternate Attorney’s Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Do you wish to have a Healthcare Power of Attorney?

Yes

No

Primary Healthcare Attorney’s Name

First Name

Last Name

Primary Healthcare Attorney’s Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Secondary Healthcare Attorney’s Name

First Name

Last Name

Secondary Healthcare Attorney’s Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country