Estate Planning Form - Law Office of Janice Joyner Panza

Preparation for Your Estate Planning Consult

First Name*

Middle Name

Last Name*

Cell Phone

Home Phone

Email

Address Line 1*

Address Line 2

State*

Zip Code*

Date of Birth*

Marital Status

Estate Planning Documents Desired

Will (Final Instructions) Power of Attorney (Financial Matters) Advanced Directive Health Care Power of Attorney Other

Name of Next of Kin

Relationship to You

Phone Number of Next of Kin

Address of Next of Kin

Who do you prefer to manage your affairs once you need help, acting as Executor?

Address of Executor

Phone Number of Executor

Names of Significant Family Members Such as Children and Step-Children

Family, Friends, or Recipients of Material Goods

Specific Gifts, money or items you specify for a person or organization, and recipients.