Legal Planning Questionnaire

LEGAL PLANNING QUESTIONNAIRE

This Legal Planning Questionnaire is made effective as of by and between Client Name: and Legal Advisor Name: .

RECITALS

WHEREAS, Client seeks to provide to Legal Advisor material information and statements necessary for the preparation of legal instruments, estate plans, business succession documents, or related planning instruments (the "Planning Documents"); and

WHEREAS, Legal Advisor requires a comprehensive factual record concerning Client's personal, financial, business, and family circumstances to advise accurately and to prepare Planning Documents; and

WHEREAS, the parties intend by this Questionnaire to record Client's instructions, declarations, preferences, and disclosures for legal planning purposes, subject to the terms set forth below.

NOW, THEREFORE

In consideration of the mutual covenants set forth herein and other good and valuable consideration, the sufficiency of which is acknowledged, the parties agree that Client shall complete this Questionnaire and Legal Advisor shall use the information provided solely for the purposes described in Section 2 (Scope) and in accordance with the confidentiality and legal provisions set forth below.

1. DEFINITIONS

For purposes of this document: "Questionnaire" means this filled form and all attachments; "Confidential Information" means all oral, written, or electronic information disclosed by Client to Legal Advisor in connection with the Questionnaire, except information that is or becomes publicly available through no breach by Legal Advisor.

2. PURPOSE AND SCOPE

Legal Advisor will rely on Client's responses to prepare or advise on legal instruments including, but not limited to, wills, trusts, powers of attorney, advance health care directives, business succession plans, and related documents. Completion of this Questionnaire does not by itself create or modify any legal instrument unless executed by Client in a separate, executed document.

3. CLIENT IDENTIFICATION

4. FAMILY AND PERSONAL RELATIONSHIPS

Do you have a preferred guardian for minor children? Yes No

5. ASSETS, LIABILITIES, AND INSURANCE

Describe primary assets (real property, investment accounts, retirement accounts, life insurance policies, vehicles). For each asset indicate titleholder, approximate value, and location.

Describe liabilities (mortgages, loans, credit obligations) including creditor and approximate balance.

6. BUSINESS INTERESTS

Do you own or have an interest in any business entities (corporation, LLC, partnership, sole proprietorship)? Yes No

7. EXISTING LEGAL DOCUMENTS

Indicate whether you currently have the following: Will Yes No; Trust Yes No; Durable Power of Attorney Yes No; Advance Health Care Directive Yes No

8. BENEFICIARIES AND DISTRIBUTION PREFERENCES

State primary distribution objectives (equal shares, specific bequests, charitable gifts, trusts for minors, special needs, tax planning considerations).

9. TAX, BANKING, AND ADVISORS

10. CONFIDENTIALITY; ATTORNEY-CLIENT PRIVILEGE

Client acknowledges that communications and information provided to Legal Advisor in connection with legal advice are intended to be confidential and may be protected by the attorney-client privilege where applicable. Legal Advisor will maintain Confidential Information in accordance with professional obligations and will disclose such information only (a) with Client's prior written consent, (b) as required by law or court order, or (c) to third-party service providers engaged to assist in the preparation of Planning Documents who are bound to confidentiality.

11. REPRESENTATIONS AND WARRANTIES

Client represents and warrants that the answers and materials provided in this Questionnaire are true, complete and accurate to the best of Client's knowledge, that Client has disclosed all material information relevant to the Planning Documents, and that Client will promptly notify Legal Advisor in writing if any such information changes prior to execution of any Planning Documents.

12. NOTICES

All notices or communications required or permitted under this Questionnaire shall be in writing and delivered to the addresses set forth below (or to such other address as either party designates by written notice).

13. MISCELLANEOUS PROVISIONS

Governing Law: This Questionnaire shall be governed by and construed in accordance with the substantive laws of the jurisdiction agreed between Client and Legal Advisor as set forth in the Planning Documents, without regard to conflict of law principles.

Entire Agreement: This Questionnaire, together with any signed engagement letter between the parties, constitutes the entire agreement with respect to the subject matter hereof and supersedes all prior discussions, understandings, or agreements.

Severability: If any provision of this Questionnaire is held unenforceable or invalid, such provision shall be severed and the remaining provisions shall remain in full force and effect.

Amendments and Waiver: This Questionnaire may be amended only by a written instrument signed by both parties. No waiver of any provision shall be effective unless made in writing and signed by the party against whom enforcement is sought.

Counterparts: This Questionnaire may be executed in counterparts, each of which shall be deemed an original and all of which together shall constitute one instrument. Facsimile or electronic signatures shall be deemed original signatures for all purposes.

CERTIFICATION

By signing below, Client certifies under penalty of perjury that the information provided in this Questionnaire is accurate and complete to the best of Client's knowledge and that Client authorizes Legal Advisor to rely on this information for the preparation of Planning Documents.

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