L I V I N G  T R U S T

Your Children :

DOES YOUR SPOUSE HAVE CHILDREN NOT FROM THIS MARRIAGE? List their information on back of this page. Include name of father/mother, and date of birth.

Any deceased children? List Name and date of death on back of this page.

(List additional children on back of page one if necessary. Also list names and date of death of any deceased children, and whether from present union or prior marriage, and whether they left any children.)

Your Living Trust "Team" Successor Trustees: Manages your trust after you & your spouse pass. Indicate if you want them to be co-trustees or act alone.

                Act Alone____                                 Act Together______

Legal Name_________________________Legal Name _______________________________

Address ____________________________Address __________________________________

___________________________________   _______________________________________

Phone ____________________                      Phone ___________________________

Relationship to you____________________Relationship to you_________________________

Back-up Trustees: Take over if above people can not serve for any reason

#1 Choice Act Alone____ Act Together_____

Legal Name ___________________________ Address__________________________________

City_________________________State_____Zip Code___________Phone ________________

Relationship to you______________________

Legal Name ____________________________Address _______________________________

City_________________________State____ Zip Code____________Phone _______________

Relationship to you_________________________

Primary Beneficiaries: Who do you want to receive the rest of your assets after    your special gifts have been distributed? You can designate dollar amounts or percentages.

Name_______________________________Relationship_________________ Amount/percentage__________

Name_______________________________Relationship_________________ Amount/percentage__________

Name_______________________________Relationship_________________ Amount/percentage__________

Name_______________________________Relationship_________________ Amount/percentage__________

Name_______________________________Relationship_________________ Amount/percentage__________

Guardians for Minor Children: Responsible adults to raise your minor     children after your demise.

#1 Choice (Can be a married couple)

Name _________________________Address ____________________________________

Phone ___________                            

#2 Choice

Name _________________________Address ____________________________________

Phone ___________

Name_____________________Relationship____________ Gift_________________________

Name_____________________Reationship ____________Gift__________________________

Name_____________________Relationship____________ Gift_________________________

Name_____________________Relationship_____________Gift_________________________

Name________________________Relationship_____________________ Phone___________

Name________________________Relationship______________________Phone___________

Name________________________Relationship__________________________Phone ____________

Do You provide for someone who requires special care? Do any of your dependants (aging parents, disabled) require special care? Are they currently receiving government benefits? Is there someone else you want to provide for who is not related to you?)_________________________________________________________

Legal Description from deed, ie; Lot___Tract_____Book____Page___APN______________

_______________________________________________________________________________________
_______________________________________________________________________________________________________
Do you or your spouse have any Bank or cash equivalent accounts? (Savings, CDs, money market, etc.)

Name of Institution                                         Account number

Do you or your spouse own any stocks, bonds, or mutual funds (including company stock)?

Name of Institution/Company Account number

Do you or your spouse own a business or other partnership interests?

Name & Description of business Value and/or percentage of business

Do you and/or your spouse own any other titled property such as a motor home, boat, trailer, etc.?

Name Address Description of debt Amount

    Do you or your spouse have any special items of value such as coin collections, antiques, jewelry, etc.?

    Do you or your spouse have any special items of value such as coin collections, antiques, jewelry, etc. which you wish to give to certain people through the Trust?

Description                         Beneficiary's Name                        Relationship

___________________________________________________________________________ ___________________________________________________________________________

_______________________________________ ___________________________________

Location of safe deposit box(es):________________________________________________

Profit sharing plans, IRA's or pension plans are usually not included in Trust, but discuss            the way you list beneficiaries with me. Life insurance policies and/or annuities are usually           not included in Trust, as they have their own beneficiaries, ie: spouse, children, etc.

#1 Choice

Name___________________________Address____________________________________

 ___________________ ____________Phone________________________

#2 Choice

Legal Name _____________________Address_______________________________  ___________________ _____________Phone_______________________

Do you need a Durable Power of Attorney for property management?__________

Do you already have a Durable Power(s) of Attorney for Health Care?_________

Are you an organ donor?_____________ Do you wish to be?___________

Executor of Pour-Over Will: Steps in at your disability or death. Can be adult children, trusted friends, and/or a corporate trustee acting alone or together.

_________________ ______ ______Phone________________________

#3 Choice Act Alone _ ____Act Together______

Name____________________Address_______________________________

________________ ______________Phone_______________________