Living Trust Information Form (Short Form) Page 6
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9POUR-OVER WILL EXECUTOR CHOICES
Same persons and order as Trustees above [ ]
If married, Executor will be surviving spouse Yes ____ No ____
Executors (after surviving spouse) will serve [ ] Jointly [ ] In Succession
Name of Successor #1:
________________________________________________________________
Name of Successor #2:
________________________________________________________________
Name of Successor #3:
________________________________________________________________
If serving jointly, and one of the executors can no longer serve, the remaining co-executor will [ ] serve alone [ ] choose an
acceptable co-executor.
Guardian of minor children, if any:
I/We nominate as Guardians for my/our minor children in the event of requirement of same:
Name: ______________________________________________
Name: ______________________________________________
WE DO NOT WANT THE FOLLOWING PERSON(S) TO BE APPOINTED:
____________________________________________________
DURABLE POWER OF ATTORNEY FOR PROPERTY/FINANCIAL AGENT CHOICES
Same persons and order as Trustees above [ ]
If married, Agent will be spouse Yes ____ No ____
Agents (after surviving spouse) will serve [ ] In Succession
[ ] Jointly, two at a time [ ] Spouse will serve jointly with Next
Successor
Name of Successor #1:
________________________________________________________________
Name of Successor #2:
________________________________________________________________
Name of Successor #3:
________________________________________________________________
DURABLE POWER OF ATTORNEY FOR HEALTH CARE AGENT CHOICES
Same persons and order as Trustees above [ ]
If married, Agent will be spouse Yes ____ No ____
Agents (after surviving spouse) will serve [ ] In Succession
[ ] Jointly, two at a time [ ] Spouse will serve jointly with Next
Successor
Name of Successor #1:
________________________________________________________________
Name of Successor #2:
________________________________________________________________
Name of Successor #3:
________________________________________________________________
Health Care/Anatomical Gifts/Internment Desires
Client states:
[ ]
I DO authorize my Agent to make Anatomical Gifts [ ] I DO NOT authorize my Agent to make Anatomical Gifts
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Parent category: Legal