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Home
Services
Veteran Advocacy
Estate Planning
Elder Care
Business Planning
Asset Protection
Pricing
About
Contact Us
VA Trust Intake Form
Start Protecting Your Legacy
Veteran
Legal Name
*
First Name
Last Name
Social Security Number (no dashes)
*
Date of Birth
*
MM
DD
YYYY
Is Veteran:
*
Living
Deceased
If Deceased, Date of Death
MM
DD
YYYY
Client
Legal Name
*
First Name
Last Name
Date of Birth (if different from Veteran)
MM
DD
YYYY
Address
*
City
*
State
*
Zip/Postal Code
*
County
*
Phone
*
(###)
###
####
Email
*
Spouse (If Applicable)
Legal Name
First Name
Last Name
Date of Birth
MM
DD
YYYY
Beneficiaries
Beneficiary #1
Legal Name
*
First Name
Last Name
Relation to Client
Date of Birth
*
MM
DD
YYYY
City of Residence
*
County of Residence
*
State of Residence
*
Marital Status
*
Single
Married
Divorced
Widowed
Number of Children
*
Beneficiary #2
Legal Name
First Name
Last Name
Relation to Client
Date of Birth
MM
DD
YYYY
City of Residence
County of Residence
State of Residence
Marital Status
Single
Married
Divorced
Widowed
Number of Children
Beneficiary #3
Legal Name
First Name
Last Name
Relation to Client
Date of Birth
MM
DD
YYYY
City of Residence
County of Residence
State of Residence
Marital Status
Single
Married
Divorced
Widowed
Number of Children
If you would like to elect more than 3 beneficiaries, please add their name(s) below and include their date of birth and city, county and state of residence:
Trustee (who will be the "financial manager" of the trust)
Legal Name
*
First Name
Last Name
Relation to Client
*
Date of Birth
*
MM
DD
YYYY
City of Residence
*
County of Residence
*
State of Residence
*
Successor Trustee
Legal Name
*
First Name
Last Name
Relation to Client
*
Date of Birth
*
MM
DD
YYYY
City of Residence
*
County of Residence
*
State of Residence
*
Second Successor Trustee
Legal Name
First Name
Last Name
Relation to Client
Date of Birth
MM
DD
YYYY
City of Residence
County of Residence
State of Residence
Thank you!
