Estate Planning Individual Information Form | The Allen Firm, PC.

254.965.3185 info@allenlawfirm.com

The Allen Firm, PC
English
- English
- Spanish

Home
Meet TAF
Acorn Lawyers
- Acorn Lawyers
- Super Mom Lawyers
Connect
- Connect With Us
- Appointment Request
The Storyfield Podcast
Pay Fee

Select Page

TAF Estate Planning - Individual

Thank you for allowing The Allen Firm, PC to help you. Our Firm values people and developing personal relationships. In order to make sure your information is updated and current, please complete the following information. Please complete the following area with your detailed contact information.
Today's Date*
MM slash DD slash YYYY
Personal Information
Name:*
First Last
Address:
Street Address City State ZIP Code
Email Address:
Primary Contact Number:
Date of Birth:
MM slash DD slash YYYY
Drivers License Number and State:
Last 4 Digits of SS #:
Professional Degrees, Licenses, Certifications:
Employer Information
Employer:
Title:
Employer Address:
Length of Employment:
Gross Annual Salary:
Work Contact Number:
Work Email:
Children
How many children are you do you have?
- 1
- 2
- 3
- 4
- 5 or more
Child 1
Please add child's name, date of birth and current address.
Child 2
Please add child's name, date of birth and current address.
Child 3
Please add child's name, date of birth and current address.
Child 4
Please add child's name, date of birth and current address.
Child 5
Please add child's name, date of birth and current address.
Distribution Information
Describe how you want your estate to be distributed upon your death.
When describing your distributions to any children, relatives, or friends, please include their full name and how they are related to you,
Please describe your current financial situation.
Include life insurance, retirement, savings and other investment and financial accounts, real property, mineral interests owned and any other relevant financial information. (Note - do not include account numbers)
Executor
Who do you want to name as Executor(s) or Co-Executors of your estate?
Executor 1
Please enter full name and relation to you.
Executor 2
Please enter full name and relation to you.
Executor 3
Please enter full name and relation to you.
Executor 4
Please enter full name and relation to you.
Guardians
Who do you want to name as the Guardian(s) of your children (if you have children under age 18)?
Guardian 1
Please enter full name and relation to you.
Guardian 2
Please enter full name and relation to you.
Guardian 3
Please enter full name and relation to you.
Guardian 4
Please enter full name and relation to you.
Trustees
Who do you want to name as Trustee or Co-Trustees of any Trust to be established in your Will?
Trustee 1
Please enter full name and relation to you.
Trustee 2
Please enter full name and relation to you.
Trustee 3
Please enter full name and relation to you.
Trustee 4
Please enter full name and relation to you.
Estate Planning Documents
Under each document type please select yes or no. By selecting yes, you are requesting The Allen Firm, PC to prepare the following documents for each spouse.
Last Will and Testament
- Yes
- No
We additionally recommend the preparation of the following documents in connection with your Last Will and Testament, in order to have a more complete set of estate planning documentation.
Statutory Durable Power of Attorney
- Yes
- No
The Statutory Durable Power of Attorney allows an individual to designate an agent to act on the individual’s behalf with regard to numerous non-medical matters, such as real property transactions, banking and financial institution transactions, business operating transactions, and other personal or family matters.
Medical Power of Attorney
- Yes
- No
The Medical Power of Attorney allows the individual to designate an agent to make medical-related decisions for the individual when the individual is not able to make those decisions himself/herself due to incapacity.
HIPPA Release and Authorization – Health Insurance Portability and Accountability Act (“HIPAA”)
- Yes
- No
The HIPPA Medical Authorization allows the individual to designate person(s) who may receive protected health information about the individual, such as medical records, prescription records, treatment information, and billing information.
Directive to Physicians or Advance Directives
- Yes
- No
The Directive to Physicians or Advance Directives is a written statement which communicates your wishes about medical treatment at some time in the future when you are not able to make your wishes known because of an illness or injury.
Digital Signature*

Who We Serve

Accident Victims

Bankers

Builders / Contractors

Business Owners & Executives

Educators

Energy, Oil & Gas

Entrepreneurs & Start Ups

Executors

Families

Farmers and Ranchers

First Responders

Medical Professionals

Real Estate Professionals

Seniors

About Us

Pay Retainer

Forms

Our Mission

Our Story

Blog

Stephenville

181 S. Graham Street
Stephenville, TX 76401

Granbury

(By Appointment Only)

1315 Water’s Edge Drive, Suite 108
Granbury, Texas 76048

Aledo

(By Appointment Only)
401 FM 1187 N
Suite 100
Aledo, TX 76008