Reviewer Questionnaire

Your Name *

First Name

Last Name

Has it been more than 3 years since you reviewed your current estate plan? *

Yes

No

If you have a Trust, are there any assets that you have not transferred into your Trust? *

Yes

No

If you become disabled, is your Power of Attorney document for financial decisions older than 5 years? *

Yes

No

If you become disabled, is your Power of Attorney document for health care decisions older than 5 years? *

Yes

No

Are there any gifts you would like to make to charities at your death that have not been clearly set forth in your planning documents? *

Yes

No

Is there any personal property that you would like distributed that have not been clearly set forth in your planning documents, including the care of any surviving pets? *

Yes

No

Since you signed your planning documents, have you changed your mind about any aspect of the plan? *

Yes

No

Has the value of your assets changed since you signed your planning documents? *

Yes

No

Have you added or changed the kind of assets you own since your planning documents were signed? *

Yes

No

Have you recently been married, divorced or widowed since your estate planning documents were signed? *

Yes

No

Have you bought or sold a house or other piece of property since your planning documents were signed? *

Yes

No

Are you contemplating selling stock or other valuable assets with a low cost basis? *

Yes

No

Have you moved between states since your planning documents were signed? *

Yes

No

If you have a Living Trust, are Medicaid triggers in place to ensure that at the appropriate time Medicaid planning can be implemented? *

Yes

No

Does your estate plan name Guardians for your minor children? *

Yes

No

N/A

Since creating your estate plan, are your children now adults? *

Yes

No

N/A

Have you had children since your estate planning documents were signed? *

Yes

No

N/A

Have your children had children? *

Yes

No

N/A

Have any of your children been married, divorced or died since your planning documents were signed? *

Yes

No

N/A