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Which of the following documents are part of your existing estate plan? (click all that apply)
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Will
Revocable Trust
Irrevocable Trust
General Power of Attorney
Health Care Power of Attorney
Living Will (covering end-of-life wishes)
HIPAA Waiver
Standby Guardianship Designation
Other
Please specify:
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When did you complete or last update your estate plan?
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Within the past year
Between 1 and 3 years ago
More than 3 years ago
Have you experienced any of the following changes recently? (click all that apply)
Personal or family (e.g. baby, marriage, death, separation, divorce)
Beneficiary-related (e.g. death, poor health, money problems, divorce)
Fiduciary-related (e.g. executor, trustee, agent, guardian)
Property (e.g. asset increase, new business, new life insurance)
Employment (e.g. new job, promotion, retirement)
Health (e.g. injury, diagnosis)
Other (e.g. new NC residency, new wishes)
None of the Above
Please specify:
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Are you married?
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Yes
No
Which considerations interest and/or apply to you? (click all that apply)
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Minor children
Probate avoidance
Incapacity planning
New NC residency
Routine maintenance
Privacy over estate details
End-of-life wishes
Marital status change
None of the above
Which considerations interest and/or apply to you? (click all that apply)
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High-value property
Non-NC real estate
Pet care
Legacy planning
Blended family
Asset protection
Potential will contest
Closely-held business
None of the above
Which considerations interest and/or apply to you? (click all that apply)
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Special needs beneficiary
Tax minimization
Long-term care
Charitable giving
Unique asset(s)
Other
None of the above
Please specify:
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Name
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First
Last
Email
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Zip Code
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How did you hear about Legacy Check?
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Ad (Digital)
Ad (Print)
Ad (Radio)
Direct Mail
Legacy Gram
Social Media
Website Visitor
Word of Mouth
Other
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Submission Date
MM slash DD slash YYYY
Legacy Gram Subscription
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Phone
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