Estate Planning Intake Form

Thank you for choosing 23 Legal to plan your estate! We’re excited to get started. Please fill out your information using our secure intake form below. It may take 15-20 minutes to complete this questionnaire. Do you have a question? Contact us at: (847) 447-6004

Personal Information

Title

First Name(Required)

Enter your name as you would like it to appear on your Estate Planning documents.

Middle Name

Enter your name as you would like it to appear on your Estate Planning documents.

Last Name(Required)

Enter your name as you would like it to appear on your Estate Planning documents.

Suffix

Enter your name as you would like it to appear on your Estate Planning documents.

Birth Date(Required)

Preferred pronoun(Required)

He/him

She/her

They/them

Contact Information

Hidden

Title

Hidden

First Name(Required)

Hidden

Middle Name

Hidden

Last Name(Required)

Hidden

Suffix

Residential Address(Required)

Phone(Required)

Email(Required)

Preferred method of communication(Required)

Phone Call

Existing Estate Planning Documents:

Do you have any existing estate planning documents?(Required)

Yes

Describe the types of documents you currently have:

File

Drop files here or

Accepted file types: jpg, jpeg, png, pdf, tif, doc, docx, txt, xlsx, xlx, Max. file size: 50 MB.

If your documents are in a digital form, please attach them here.

Marriage Information

Are you married?(Required)

Yes

Marital Status(Required)

Single

Separated

Divorced

Widowed

Information for Other Person

Title

First Name

Middle Name

Last Name

Address

Phone

Preferred method of communication:(Required)

Phone Call

Marriage date:

Birth Date

Will you be creating your estate plan documents with another person that you are not married to?

Yes

What is your relationship to this person?

Title

Birth Date

First Name(Required)

Middle Name

Last Name(Required)

Suffix

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone(Required)

Email(Required)

Preferred method of communication:(Required)

Phone Call

Are you creating an estate plan together?

Yes

Whose SSN would you like to use for the trust?

If you both pass away simultaneously in an accident, is there a pension or any sort of financial reason why one of you should be deemed to survive longer than the other?

Children Information

Do you have any children?(Required)

Yes

Hidden

How many children do you have?(Required)

Please enter a number greater than or equal to 1.

Child #1 Full Legal Name(Required)

First Last

Child #1 Birth Date(Required)

Does child #1 have a different address than yours?(Required)

Yes

Child #1 Address:(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Does child #1 have a phone number?(Required)

Yes

Child #1 Phone Number:(Required)

Does child #1 have an email address?(Required)

Yes

Child #1 Email Address:(Required)

Does your child have special needs or considerations?(Required)

Yes

Special Considerations:(Required)

Is your child a minor?(Required)

Yes

Do you have another child?(Required)

Yes

Child #2 Full Legal Name(Required)

First Last

Child #2 Birth Date(Required)

Does child #2 have a different address than yours?(Required)

Yes

Child #2 Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Does child #2 have a phone number?(Required)

Yes

Child #2 Phone Number:(Required)

Does child #2 have an email address?(Required)

Yes

Child #2 Email Address:(Required)

Does child #2 have special needs or considerations?(Required)

Yes

Special Considerations:(Required)

Is your child a minor?(Required)

Yes

Do you have another child?(Required)

Yes

Child #3 Full Legal Name(Required)

First Last

Child #3 Birth Date(Required)

Does child #3 have a different address than yours?(Required)

Yes

Child #3 Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Does child #3 have a phone number?(Required)

Yes

Child #3 Phone Number:(Required)

Does child #3 have an email address?(Required)

Yes

Child #3 Email Address:(Required)

Does child #3 have special needs or considerations?(Required)

Yes

Special Considerations:(Required)

Is child #3 a minor?(Required)

Yes

Do you have another child?(Required)

Yes

Child #4 Full Legal Name(Required)

First Last

Child #4 Birth Date(Required)

Does child #4 have a different address than yours?(Required)

Yes

Child #4 Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Does child #4 have a phone number?(Required)

Yes

Child #4 Phone Number:(Required)

Does child #4 have an email address?(Required)

Yes

Child #4 Email Address:(Required)

Does child #4 have special needs or considerations?(Required)

Yes

Special Considerations(Required)

Is child #4 a minor?(Required)

Yes

If you have more than four children, please list any additional names, birth dates, and other important information below:

List each additional child's personal and contact information here.

Pet Information

Would you like to include any pets in your estate plan?

Yes

Hidden

List the names of your pets:

Hidden

Name

Hidden

Phone

Provide the name, address and phone number of the person you would like to appoint as your pets' guardian.

Hidden

Address

Same as previous

Street Address Address Line 2 City State ZIP Code

Hidden

Address

Same as previous

Street Address Address Line 2 City State ZIP Code

Beneficiaries

Please add any individuals you would like to name as a beneficiary, other than your spouse and children.

Financial Information

Hidden

Provide the name of any financial institutions that you have an account with:

Hidden

Do you have any safe deposit boxes?(Required)

Yes

Hidden

Location

Hidden

Do you work with a financial advisor?

Yes

Hidden

Financial Advisor's Name

First Last

Hidden

Financial Advisor's Email

Hidden

Do you work with an accountant?

Yes

Hidden

Accountant's Name

First Last

Hidden

Accountant's Email

Hidden

Assets

Provide the monetary value you own in each of the following categories

Hidden

Stocks or Bonds

Hidden

Real Estate

Hidden

Insurance Policies

Hidden

Personal Property

Hidden

Vehicles, RVs, Boats

Related Professionals

Do you have a financial advisor?

Yes

Financial Advisor's Contact Information:

Name(Required)

Phone(Required)

Email(Required)

Do we have permission to contact this individual about your estate planning documents in the future?(Required)

Yes

Do you have an accountant?

Yes

Accountant's Contact Information:

Name(Required)

Phone(Required)

Email(Required)

Do we have permission to contact this individual about your estate planning documents in the future?(Required)

Yes

Goals

Please outline any goals or concerns that you have about creating an Estate Plan:

Estate Planning Intake Form

Thank you for choosing 23 Legal to plan your estate! We’re excited to get started. Please fill out your information using our secure intake form below. It may take 15-20 minutes to complete this questionnaire. Do you have a question? Contact us at: (847) 447-6004

Personal Information

Contact Information

Existing Estate Planning Documents:

Marriage Information

Information for Other Person

Children Information

Pet Information

Beneficiaries

Financial Information

Assets

Related Professionals

Financial Advisor's Contact Information:

Accountant's Contact Information:

Goals

1834 Walden Office Square Ste. 460, Schaumburg, IL 60173

(847) 447-6004

Email Ben Weaver