Estate Planning Form

The Law Offices of Carolina Nunez, P.A.

About You

First name

Last name

Email

Phone

Date of Birth

Month

Day

Year

Address

Martial Status

To accurately guide you, you must provide information about your spouse or ex-spouse for asset protection to the fullest extent of the law.

Do you have children under the age of 18?

Your Florida Estate Planning Goals

Explain 'other' selection below:

Please describe other goals not listed here.

Your Traditional Assets

Please list the amounts of bank/cash assets you have. This is not because we want to snoop -- we just need to know to protect your assets and apply the correct language in your legal documents. It also helps us assist with an accurate quote.

Example:

Bank of America - Checking: $10,413.15

TD Bank - Savings: $7,812.92

Do you have life insurance?

Your Digital Assets

Do you own Digital Assets/Crypto? If so, please list below. If you do not, just type "N/A".

Note: We will ask for access methods and location/method of storage in person. Please give an approximate value based on the date of this form.

Do NOT include seed phrases, passcodes, or private keys.

Example:

Bitcoin - Coinbase - $4,012.13

Nominating Agents and Beneficiaries

Please list your Health Care Agent along with two alternates.

Example:

First Choice: John Doe - Orlando, Florida - (407) 123-4567

Second Choice: Jerry Seinfeld - Tampa, Florida - (407) 234-5678

Third Choice: Elon Musk - Miami, Florida - (407) 456-7891

Please list your Power of Attorney agents along with two alternates.

Example:

First Choice: John Doe - Orlando, Florida - (407) 123-4567

Second Choice: Jerry Seinfeld - Tampa, Florida - (407) 234-5678

Third Choice: Elon Musk - Miami, Florida - (407) 456-7891

Please list your beneficiaries, city and state where they reside, percentages they will inherit, and their relationship to you. Also list potential beneficiaries.

Example:

First Choice: John Doe - Orlando, Florida - 100% - Son

Second Choice: Jerry Seinfeld - Tampa, Florida - 50% - Grandson

Third Choice: Elon Musk - Miami, Florida - 50% - Grandson

You're Almost Done!

How did you hear about us?

I certify that the information I have provided in this form is true and complete to the best of my knowledge.

I understand that this information will be kept confidential by The Law Offices of Carolina Nunez, P.A. for purposes of evaluating my case.

I further understand that the completion of this form does not create an attorney-client relationship, and legal representation will only begin after a formal written agreement is signed and accepted by the firm.

Signature of Potential Client

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By signing above, I acknowledge and agree to the above terms. I understand that my electronic signature has the same legal validity and enforceability as a handwritten signature.

Estate Planning Consult

$200

Estate Planning Form

The Law Offices of Carolina Nunez, P.A.

About You

Your Florida Estate Planning Goals

Your Traditional Assets

Your Digital Assets

Nominating Agents and Beneficiaries

You're Almost Done!

WINTER PARK
Main Office

386-PLEITOS

407-900-FIRM

DAYTONA BEACH
Office - Accidents

407-900-FIRM

386-PLEITOS