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Estate Planning Questionnaire
Your Full Legal Name: ................................................................................................................................................................................................................................................... Date of Birth: ................................................................................................................................................................................................................................................................. Address: ......................................................................................................................................................................................................................................................................... County: .......................................................................................................................................................................................................................................................................... Home/Cell Telephone: .................................................................................................................................................................................................................................................. Email: ............................................................................................................................................................................................................................................................................ Spouse's Full Name (Type "Unmarried" if appropriate): ............................................................................................................................................................................................ Residency: Do you and your spouse consider yourselves residents of North Carolina?  Yes  No
Family Information
Living Children
Name:............................................................................................................................................................................................................................................................................. DOB: ............................................................................................................................................................................................................................................................................... Are any children handicapped? Are any in poor health or have special needs?  Yes  No
Guardian for Minor Children: If both you and your spouse were deceased, whom would you name as a guardian for your minor children? Catastrophic Option:
If a catastrophic event left you, your spouse, and all lineal descendants deceased, where would you wish your estate to go?
Charitable Beneficiaries:
Would you like to remember a charity with a gift?
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