12 WASHINGTON AVENUE – SUITE 250
GRAND HAVEN, MICHIGAN 49417
TELEPHONE: 616.847.1234 FAX: 616.847.1223
WWW.THIRDCOASTLAW.COM
CONFIDENTIAL PERSONAL INFORMATION FOR ESTATE PLANNING
What is the current date? __________________________
For non-married individuals, please use “Individual 1” column.
Individual 1 Individual 2
Name __________________________ ___________________________
Also known as __________________________ ___________________________
Social Security No. __________________________ ___________________________
Date of Birth __________________________ ___________________________
Email Address __________________________ ___________________________
Home Address __________________________ ___________________________
__________________________ ___________________________
__________________________ ___________________________
County of Residence __________________________ ___________________________
Telephone No. __________________________ ___________________________
Living Parents __________________________ ___________________________
__________________________ ___________________________
Previously Married Yes: ______ No: _______ Yes: _______ No: _______
U.S. Citizen Yes: ______ No: _______ Yes: _______ No: _______
Marriage
Date of Marriage ______________________________________________________
Do you have a prenuptial or postnuptial agreement? Yes:_______ No:_______
Miscellaneous Information
Do you have a Will? Yes:_______ No:_______
Do you have a Trust? Yes:_______ No:_______
Do you have a financial or medical power of attorney? Yes:_______ No:_______
Where do you keep your important documents? Home: _____ Office:_____ Safe Deposit
Box:_____ Other:_________________________________________________________
If you have a safe deposit box, where is it located? _______________________________
TEST