Shaffer Law OfficeLawrenceburg, Tennessee

Shaffer Law Office

Estate Planning Intake

Please complete as much of this form as you can. All information is confidential and protected by attorney-client privilege. You can leave fields blank if you are unsure — we will discuss everything at your appointment.

Client Information

Your personal and contact details

Full Legal Name*

Date of Birth

Social Security Number

Street Address

City

State

Zip Code

Phone Number*

Email Address*

Occupation

Employer

Marital Status

Spouse Full Legal Name

Spouse Date of Birth

Spouse Social Security #

Spouse Occupation

Spouse Employer

Any prior marriages?

Children & Dependents

Do you have children?

Any minor children (under 18)?

Any children from a prior relationship?

Other dependents (elderly parents, disabled relatives, etc.)

Documents Requested

Select all that apply — we can discuss recommendations at your appointment

Which documents are you interested in?

Beneficiary Designations

Who should receive your estate?

Primary Beneficiary Name

Relationship to You

Contingent Beneficiary Name

Relationship to You

Special bequests (specific items or amounts to specific people)

Personal Representative / Executor

Who will carry out the terms of your will?

Executor Full Name

Relationship to You

Executor Phone

Alternate Executor Full Name

Alternate Executor Relationship

Power of Attorney

Who will manage your financial and healthcare decisions if you are unable to?

Financial / Durable POA

Agent Full Name

Relationship to You

Agent Phone

Alternate Agent Full Name

Alternate Agent Relationship

Healthcare POA

Healthcare Agent Full Name

Relationship to You

Healthcare Agent Phone

Guardian for Minor Children

Only required if you have children under 18

Guardian Full Name

Relationship to You

Guardian Phone

Alternate Guardian Full Name

Alternate Guardian Relationship

Real Property

Homes, land, rental property

Do you own real estate?

Financial Assets

You do not need exact figures — approximate values are fine

Bank / Checking Accounts

Savings / Money Market

Investment / Brokerage Accounts

Retirement Accounts (IRA, 401k, etc.)

Life Insurance Policies

Business Interests

Other Assets (vehicles, jewelry, collectibles, etc.)

Approximate Total Estate Value

Debts & Liabilities

Do you have any significant debts beyond a mortgage?

Special Instructions & Notes

Anything else we should know before your appointment

Special instructions or wishes

Do you have any existing estate planning documents?

How did you hear about us?

Additional notes or questions

Upload Documents

Optional — attach any existing estate planning documents, deeds, or other relevant files

Click to upload or drag and drop

PDF, Word, JPG, PNG — up to 20 MB each, max 10 files

Common documents to upload: existing will or trust, deeds to real property, life insurance policy pages, retirement account statements, or any prior power of attorney documents. All uploads are stored securely and only accessible to Shaffer Law Office.

Ready to Submit?

Your information will be sent securely to Shaffer Law Office. We will follow up to schedule your appointment.