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| OUR GOAL—YOUR Complete Satisfaction and UnderstandingShould you order this document from Spiegel & Utrera, P.A., Spiegel & Utrera, P.A., will incorporate your basic information into a draft document that will be conveyed to you for your review and make reasonable changes upon request. |
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| Please complete where applicable |
| Name: | *required |
| City: | |
| State: | |
| Phone Number: | *required |
| Cellular Phone: | |
| Email: | *required |
| | Please verify that you entered a correct address. |
| Fax: | |
| What do some of these terms mean? Click here for a Glossary. |
| Name of Trust: | |
| Type of Trust: | Individual Revocable Living Trust |
| A/B (Marital Exemption) Trust |
| Irrevocable Living Trust |
| Irrevocable Life Insurance Trust |
| Special Needs Trust |
| Settlor: | |
| Co-Settlor: | |
| Trustee: | |
| Co-Trustee: | |
| Successor Trustee: | |
| Successor Co-Trustee: | |
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| Specific Gifts or Bequests from the Trust |
| Name of Gift or Bequest Recipient (1) | |
| Optional Address of Gift or Bequest Recipient (1) | |
| Gift Recipient 1's Relationship to Settlor | |
| Describe Gift | |
| |
| Name of Gift or Bequest Recipient (2) | |
| Optional Address of Gift or Bequest Recipient (2) | |
| Gift Recipient 2's Relationship to Settlor | |
| Describe Gift | |
| |
| Name of Gift or Bequest Recipient (3) | |
| Optional Address of Gift or Bequest Recipient (3) | |
| Gift Recipient 3's Relationship to Settlor | |
| Describe Gift | |
| |
| Name of Gift or Bequest Recipient (4) | |
| Optional Address of Gift or Bequest Recipient (4) | |
| Gift Recipient 4's Relationship to Settlor | |
| Describe Gift | |
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| Beneficiaries from the Trust |
| Name of Beneficiary 1 of Trust | |
| Optional Address of Beneficiary 1 of Trust | |
| Beneficiary 1's Relationship to Settlor | |
| Beneficiary 1's Percentage of Residual of Trust (after Bequests, if any) | |
| |
| Name of Beneficiary 2 of Trust | |
| Optional Address of Beneficiary 2 of Trust | |
| Beneficiary 2's Relationship to Settlor | |
| Beneficiary 2's Percentage of Residual of Trust (after Bequests, if any) | |
| |
| Name of Beneficiary 3 of Trust | |
| Optional Address of Beneficiary 3 of Trust | |
| Beneficiary 3's Relationship to Settlor | |
| Beneficiary 3's Percentage of Residual of Trust (after Bequests, if any) | |
| |
| Name of Beneficiary 4 of Trust | |
| Optional Address of Beneficiary 4 of Trust | |
| Beneficiary 4's Relationship to Settlor | |
| Beneficiary 4's Percentage of Residual of Trust (after Bequests, if any) | |
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| ASSETS - Please indicate the assets held by the testator or testatrix below and describe as applicable. |
| Residence/Home (Please provide a short description including the name(s) or the owner(s) that hold title, mortgage(s), (quantity and amount(s)), and approximate value). | |
| City of Residence/Home | |
| State of Residence/Home | |
| Other Real Estate (Please provide a short description including the name(s) of the owner(s) that hold title, mortgage(s), (quantity and amount(s)), and approximate value). | |
| City of Other Real Estate | |
| State of Other Real Estate | |
| Cash and cash equivalents (Please provide a short description including the name(s) of the account owner(s) and approximate value). | |
| City where Cash and Cash Equivalents Located | |
| State where Cash and Cash Equivalents Located | |
| Investments | |
| City where Investments Located | |
| State where Investments Located | |
| Life Insurance | |
| City where Life Insurance negotiated/entered into | |
| State where Life Insurance negotiated/entered into | |
| IRA Accounts | |
| City where IRA Account services negotiated/entered into | |
| State where IRA Account services negotiated/entered into | |
| Notes, Mortgages and Obligations | |
| City where Notes, Mortgages and Obligations negotiated/executed | |
| State where Notes, Mortgages and Obligations negotiated/executed | |
| |
| I have questions, please don't initiate the ordering process without speaking with me. |
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