C. Flowers Law, PLLC
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BACKGROUND INFORMATION

The information you provide in this section provides us with information about you, your age, marital status, where you live, and how best to contact you.

Client 1

Contact information

Client 1 Name(Required)
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Client 1 Address
Other names such as maiden names, used to title property and accounts
Client 1 Citizenship
Is It okay to communicate with Client 1 via your E-mail address(Required)
Are you Married Client 1?(Required)
Are you Widowed Client 1?(Required)
Are you Divorced Client 1?(Required)
Are either of Client 1 parents still living?(Required)
Are any of Client 1 grandparents still living?(Required)

Client 2

Client 2 Full Legal Name
Name most often used to title property and accounts
MM slash DD slash YYYY
Client 2 Citizenship
Client 2 Address
Is it okay to communicate with Client 2 via your E-mail address?
Are you Married Client 2?
Are you Widowed Client 2?
Are you Divorced Client 2?
Are either of Client 2 parents still living?
Are either of Client 2 grandparents still living?

CHILDREN AND/OR OTHER FAMILY MEMBERS OR BENEFICIARIES

List the information about the Children/other family members/beneficiaries
Name
Age
Relation
 

PLANNING OBJECTIVES/FAMILY VALUES

One of our goals is to assist you in identifying your estate planning objectives and family values so that we can focus our conversations on the issues most important to you. Please rate the following planning objectives and family values on a scale of 1 to 5 as to how important they are to you. (5 critical, 4 very important, 3 important, 2 slightly important, 1 unimportant, N/A if inapplicable). Feel free to leave blank any item you do not wish to rank.

Protect Your Children or Other Beneficiaries

From predators who can discover inheritance amounts and target young or vulnerable beneficiaries:
From claims of divorced spouses to take half of your child or beneficiary’s inheritance
From creditors’ claims (such as car accident plaintiffs, credit cards companies, etc.)
From the stress and delays of the average 6-16 month process of probate
From the financial immaturity resulting in a quick loss of an inheritance
From sharing assets with heirs you would rather disinherit
From litigation claims by disinherited heirs
Are you parents?(Required)
Are you special needs beneficiary?(Required)
From relatives who would be poor, abusive or even dangerous guardians or from foster care
From acquaintances and relatives who should not be allowed to be alone with your children
from neglect in the government care system

Preserve and Maximize Assets

By minimizing taxes during your life (income taxes, capital gains taxes, estate taxes on inheritances you expect to receive)
By minimizing or eliminating estate taxes upon your death (up to 55% of your assets and life insurance benefits)
By reducing estate administration costs through probate avoidance
Ensure that your family has enough life insurance to provide a comfortable lifestylecing estate administration costs through probate avoidance
By ensuring that your assets are passed to your descendants and not given away to outsiders, such as to their spouses, creditors, or the government

Protect Yourself and Your Spouse

From creditor claims (such as car accident plaintiffs, credit card companies, etc)
From conservatorship proceedings (aka “living probate” or a court-ordered arrangement where a judge appoints a person to care for you) if you become incapacitated
From probate delays and stress upon your death or the death of your partner
From hospital policies requiring life sustaining procedures when you would rather not endure them
From healthcare decisions made by people other than those you trust most

Taking Charge of Your Life

Get your financial life organized
Have clarity about your life purpose, goals and dreams
Benefit a charitable organization or activity
Support a common family goal through coordinated planning
Have a plan to leave the world a better place
Leave behind specific intellectual, spiritual, and human assets in addition to your financial assets
By specifying the values, insights, stories, and experiences you want passed on to your children and how you want the money you leave behind used for your children
By providing instructions, people, and assets to support your special needs beneficiaries above a poverty lifestyle
Are you a Business Owner?(Required)
By providing for the orderly continuation and transfer of family business interests rather than a distress sale

Family Values

Cultural values such as art, music, travel
Economic values such as financial responsibility, frugality, savings
Educational values such as study, self-improvement, academic achievements, lifelong learning

ASSET INFORMATION

REAL PROPERTY

“Character” of Property
For each client's property, please indicate whether it is the client's "Community Property" (or CP) or "Separate Property" (or SP).
"Community Property" is property you acquire while you are married and is owned equally by both spouses.
In Texas, the presumption is all property acquired during marriage is community property.
"Separate Property" is property that is owned or claimed before marriage, received as a gift or inheritance, some personal injury recoveries. For example if Client #1 owns separate property, list as "CL1 SP"
If unsure, enter "?"
“Title” of Property
"Title" of property is important for how property is owned. For example, is it owned as Joint Tenancy or Tenants in Common?
"Joint Tenancy" is a legal arrangement where two or more people own property together. If one joint tenant dies, their share automatically transfers to the surviving joint tenant(s).
"Tenants in Common" is when two or more individuals own a property together, but each owner's share can be unequal, and there is no automatic right of survivorship.
Owner of Property Use
Character
If property is Community Property CP
If property is Separate Property of Client 1 CL1
If property is Separate Property of Client 2 CL2
Title
If property is held in Joint Tenancy JT
If property is held as Tenants in Common TIC
If you cannot determine how the property is owned ?
Please list information about your real properties
Name of Property
Character
Title
 

FURNITURE AND PERSONAL EFFECTS

Please list information about your furniture and personal effects
Type of article
Value
 

AUTOMOBILES, BOATS, AND RVs

Please list automobiles, boats and RVs
Year
Make
Model
Vehicle Identification No. [VIN]
 
Please list automobiles, boats and RVs
Year
Make
Model
Vehicle Identification No. [VIN]
 

BANK & SAVINGS ACCOUNT

Type: Checking Account “C”, Savings Account “S”, Certificates of Deposit “CD”, Money Market “MM” (IRAs and 401(k)s listed below) NOTE: If Account is in your spouse’s name for the benefit of a minor, please specify minor’s name.
Please list information about your bank accounts
Bank name
Account Number
Minor Name
Type
 

INVESTMENT ACCOUNTS, BONDS, STOCKS, AND STOCK OPTIONS, NOT INCLUDING RETIREMENT ACCOUNTS)

List any and all investment accounts (IA), bonds (B), stocks (S) and stock options (SO) you have an interest in. If including stock options, please indicate value of vested and unvested options separately. If held in a brokerage account, lump them together under each account.
Please list information about your Investment Account, Bond, Stock or Stock Option
Name of investment account
Type of investment account
 

LIFE INSURANCE POLICIES AND ANNUITIES

Types: Term (T), Whole Life (WL), Split Dollar (SD), Group Life (GL), Annuity (A).
Please list the information about your Life insurance policies and Annuities
Name of policy
Type of policy
 

RETIREMENT PLANS

Pension (P), Profit Sharing (PS), H.R.10, IRA, SEP, 401K
Please list your retirement plans
Retirement plan name
Type of retirement plan
 

BUSINESS INTERESTS

General and Limited Partnerships (GL), Sole Proprietorships (SP), Privately Owned Corporations (C), Oil Interests (O), Farm and Ranch Interests (F&R)
Please list your business interests
Name of Business
Type of Business
 

MONEY OWED TO YOU

Mortgages or promissory notes payable to you, or other moneys owed to you
Please list the information about the money owed to you
By whom
Type of money owned
 

ANTICIPATED INHERITANCE, GIFT, OR LAWSUIT JUDGMENT

Gifts or Inheritances that you expect to receive at some time in the future; or moneys that you anticipate receiving through a judgment in a lawsuit. Describe in appropriate detail.

OTHER ASSETS

Other property is any property that you have that does not fit into any listed category
Please list all of your other assets

Total Assets

E-Affirmation

E-Affirmation

PEOPLE WHO ADVISE YOU

Your various advisors play a key role in the establishment of your estate plan. For example, your financial advisor and life insurance agent may need to be contacted to confirm/change beneficiary designations and titling of accounts.

Accountant/Tax Advisor

Accountant/Tax Advisor Name

Financial Advisor

Financial Advisor Name

Life Insurance Agent

Life Insurance Agent Name

Other Advisor

Other Advisor Name

POTENTIAL BENEFICIARIES

This section asks you to identify all potential beneficiaries of your estate. NOTE: Listing a person or particular organization in this section is not a firm indication of your decision to provide for an individual or make a bequest. Rather, it is simply a way of identifying potential beneficiaries for discussion purposes.

Potential Individual Beneficiaries – Primary Beneficiaries

Please list information about Primary Beneficiaries
Name
Age
Phone Number
Street Address
City
State
Zip
 

Potential Individual Beneficiaries – Alternate Beneficiaries

Please list information about Alternate Beneficiaries
Name
Age
Phone Number
Street Address
City
State
Zip
 

Potential Charitable/Non-Profit Beneficiaries – church, college, social club, favorite philanthropy, etc.

Please list information about Charitable/Non-Profit Beneficiaries
Name
Type
Phone Number
Street Address
City
State
Zip
 

NOMINATION OF POWERS

Identify all potential Trustees, Executors, Financial Agents, Health Care Agents, Guardians, and Guardians for Pets. These individuals should be over 18 years old.

LONG TERM GUARDIAN FOR MINOR CHILDREN - [CLIENT 1]

If you have children under the age of 18, list those persons who you would wish to raise and love them in the manner closest to the way you do.
Please list the information about INITIAL CHOICE for the Long Term Guardian For Minor Children-Client 1
Name
Age
Phone Number
Relation
 
Please list the information about BACK UP for the Long Term Guardian For Minor Children-Client 1
Name
Age
Phone Number
Relation
 

LONG TERM GUARDIAN FOR MINOR CHILDREN - [CLIENT 2]: If Client 1 is NOT the parent.

If you have children under the age of 18, list those persons who you would wish to raise and love them in the manner closest to the way you.
Please list the information about INITIAL CHOICE for the Long Term Guardian For Minor Children-Client 2
Name
Age
Phone Number
Relation
 
Please list the information about BACK UP for the Long Term Guardian For Minor Children-Client 2
Name
Age
Phone Number
Relation
 

SHORT TERM GUARDIAN FOR MINOR CHILDREN - [CLIENT 1]

If you have children under the age of 18, list those persons who you would wish to raise and love them in the manner closest to the way you.
Please list the information about INITIAL CHOICE for the Short Term Guardian For Minor Children-Client 1
Name
Age
Phone Number
Relation
 
Please list the information about BACK UP for the Short Term Guardian For Minor Children-Client 1
Name
Age
Phone Number
Relation
 

SHORT TERM GUARDIAN FOR MINOR CHILDREN - [CLIENT 2]: If Client 1 is NOT the parent.

If you have children under the age of 18, list those persons who you would wish to raise and love them in the manner closest to the way you.
Please list the information about INITIAL CHOICE for the Short Term Guardian For Minor Children-Client 2
Name
Age
Phone Number
Relation
 
Please list the information about BACK UP for the Short Term Guardian For Minor Children-Client 2
Name
Age
Phone Number
Relation
 

PERSONAL REPRESENTATIVE/EXECUTOR - [CLIENT 1]

Upon your death, who do you want to manage and distribute the assets you leave in your estate?
Please list the information about INITIAL CHOICE for Personal Representative/Executor-Client1
Name
Age
Phone Number
 
Please list the information about BACK-UP for Personal Representative/Executor-Client1
Name
Age
Phone Number
 

PERSONAL REPRESENTATIVE/EXECUTOR - [CLIENT 2]

Upon your death, who do you want to manage and distribute the assets you leave in your estate?
Please list the information about INITIAL CHOICE for Personal Representative/Executor-Client 2
Name
Age
Phone Number
 
Please list the information about BACK-UP for Personal Representative/Executor-Client 2
Name
Age
Phone Number
 

TRUSTEE - [CLIENT 1]

Upon your death, who do you want to manage and distribute the assets you leave in your trust estate for children?
Please list the information about INITIAL CHOICE for Trustee - Client 1
Name
Age
Phone Number
 
Please list the information about BACK UP for Trustee - Client 1
Name
Age
Phone Number
 

TRUSTEE - [CLIENT 2]

Upon your death, who do you want to manage and distribute the assets you leave in your trust estate for children?
Please list the information about INITIAL CHOICE for Trustee - Client 2
Name
Age
Phone Number
 
Please list the information about BACK UP for Trustee - Client 2
Name
Age
Phone Number
 

GUARDIAN FOR PETS - [CLIENT 1]

If you are interested in setting up a pet trust, please complete this section.
Please list the information about INITIAL CHOICE for Guardian for pets - Client 1
Name
Age
Phone Number
 
Please list the information about BACK UP for Guardian for pets - Client 1
Name
Age
Phone Number
 

GUARDIAN FOR PETS - [CLIENT 2]

If you are interested in setting up a pet trust, please complete this section.
Please list the information about INITIAL CHOICE for Guardian for pets - Client 2
Name
Age
Phone Number
 
Please list the information about BACK UP for Guardian for pets - Client 2
Name
Age
Phone Number
 

FINANCIAL AGENTS - [CLIENT 1]

If you were incapacitated for any period of time, who would you want to make decisions for you with regard to your financial affairs?
Please list the information about INITIAL CHOICE for Financial Agents - Client 1
Name
Age
Phone Number
 
Please list the information about BACK UP for Financial Agents - Client 1
Name
Age
Phone Number
 

FINANCIAL AGENTS - [CLIENT 2]

If you were incapacitated for any period of time, who would you want to make decisions for you with regard to your financial affairs?
Please list the information about INITIAL CHOICE for Financial Agents - Client 2
Name
Age
Phone Number
 
Please list the information about BACK UP for Financial Agents - Client 2
Name
Age
Phone Number
 

HEALTH CARE AGENTS - [CLIENT 1]

If you were incapacitated for any period of time, who would you want to make decisions for you with regard to your health care?
Please list the information about INITIAL CHOICE for Health Care Agents - Client 1
Name
Age
Phone Number
 
Please list the information about BACK UP for Health Care Agents - Client 1
Name
Age
Phone Number
 
Do you (client 1) want to provide that the moment of your death not be unnecessarily prolonged by artificial means or measures?
Do you (client 1) want to provide that your organs and tissues should be made available for transplant purposes?

HEALTH CARE AGENTS - [CLIENT 2]

If you were incapacitated for any period of time, who would you want to make decisions for you with regard to your health care?
Please list the information about INITIAL CHOICE for Health Care Agents - Client 2
Name
Age
Phone Number
 
Please list the information about BACK UP for Health Care Agents - Client 2
Name
Age
Phone Number
 
Do you (client 2) want to provide that the moment of your death not be unnecessarily prolonged by artificial means or measures?
Do you (client 2) want to provide that your organs and tissues should be made available for transplant purposes?

OTHER CONCERNS

THANK YOU

When you are finished, please click the "Submit" button.
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