Bryant Law PLLC

242 Tucker Drive
Brandon, MS 39042

601-573-2922

Please complete this questionnaire to the best of your ability. Don't worry if you don't have every answer - we'll review everything during your consultation.

Your responses are confidential and help us design a plan that reflects your priorities and family situation.

Personal and Contact Information

Please enter your name and contact details. If you're married, we'll ask for your spouse's information next.

Contact information: Contact 1

Prefix

First name *

Middle name

Last name *

Date of birth

Emails

Email Address *

Type

Upon submission, a copy of this form will be sent to the primary email.

Add email

Addresses

Street address

Country

City

State/Region

Zip/Postal code

Address type

Add address

Phone numbers

Phone number

Type

Add phone number

Marital & Family Status

If you're married or have children, we'll ask for some basic info here. If you're not sure how to answer something, leave it blank - we'll follow up.

Are you married? If yes, fill in the contact information below for your spouse.

Yes

Contact information: Contact 2

Prefix

First name *

Middle name

Last name *

Date of birth

Emails

Email Address *

Type

Add email

Addresses

Street address

Country

City

State/Region

Zip/Postal code

Address type

Add address

Phone numbers

Phone number

Type

Add phone number

Date of Marriage

Is this your first marriage?

Yes

Do you have children? If yes, fill out the below information for each child. If you have more than 4 children, just let us know during the meeting or in the final comments section of this form.

Yes

Child 1 - Full Name

Date of Birth

Any special needs or medical conditions?

Yes

Child 2 - Full Name

Date of Birth

Any special needs or medical conditions?

Yes

Child 3 - Full Name

Date of Birth

Any special needs or medical conditions?

Yes

Child 4 - Full Name

Date of Birth

Any special needs or medical conditions?

Yes

Additional Notes:

Current Estate Planning Documents

Please let us know if you already have any estate planning documents in place. If married, please answer the same questions for your spouse.

Do you or your spouse have a will? Check all that apply.

YouSpouseUnsureNo

Do you or your spouse have a trust? Check all that apply.

YouSpouseUnsureNo

Do you or your spouse have a durable power of attorney? Check all that apply.

YouSpouseUnsureNo

Do you or your spouse have an advance health care directive? Check all that apply.

YouSpouseUnsureNo

Do you have any medical conditions or diagnoses that could affect planning?

Yes

Does your spouse have any medical conditions or diagnoses that could affect planning?

Yes

What Do You Hope This Plan Accomplishes?

(Optional) What are the most important things you're hoping to accomplish with your estate plan?

If you already know what you'd like your estate plan to accomplish - like protecting or providing for your kids, supporting a specific person or cause, etc. - feel free to type that here. If you're not sure yet, no problem. You'll have a clearer picture after our meeting.

People and/or Organizations You May Want to Provide For

This is a general list of who you may want to include in your estate. These are not final choices - we'll review everything at the meeting.

Many clients, if married with children, leave everything to their spouse, then to their children equally if their spouse has passed away. If that's your plan, just check "Yes" below - no need to list each person. If you answer "No", please list the names and shares of your intended beneficiaries below.

Yes

Beneficiary 1 - Full Name

Relationship

Percentage or Share of the Estate

Beneficiary 2 - Full Name

Relationship

Percentage or Share of the Estate

Beneficiary 3 - Full Name

Relationship

Percentage or Share of the Estate

Do you intend to leave anything to a charitable organization?

Yes

Below is a place for you to provide additional information or clarity that you feel necessary for the planning process regarding beneficiaries.

People You Trust with Key Responsibilities

These individuals will help carry out your wishes if something happens to you. If you're unsure about who to choose or what these roles mean, that's totally okay - just skip what you're not ready to answer. We'll go over all of this in your meeting.

Here's a brief explanation of each role:

Executor: Handles your estate after death - Paying debts, filing documents, distributing assets.
Trustee: Manages assets held in trust, often for children or beneficiaries until they reach certain ages.
Guardian: Cares for your minor children if both parents pass away.
Power of Attorney (POA): Makes financial or legal decisions on your behalf if you're alive but you are incapacitated or unable to make decisions.
Health Care Agent: Makes medical decisions for you if you cannot make them for yourself.

For each role below, you can list backups and indicate whether your spouse will name the same individuals. We'll review and confirm all choices in your meeting.

Executor

Would you like to name someone as your executor?

Yes

Will your spouse name the same person as executor?

Yes

Would you like to name an alternate executor?

Yes

Will your spouse name the same person as alternate executor?

Yes

Would you like to name a second alternate executor?

Yes

Will your spouse name the same person as second alternate executor?

Yes

Trustee - Person to Manage Trust Assets for Others

Would you like to name someone as your trustee if a trust is created?

Yes

Will your spouse name the same person as trustee?

Yes

Would you like to name an alternate trustee?

Yes

Will your spouse name the same person as alternate trustee?

Yes

Guardian - Who Would Care for Your Minor Children

Would you like to name a guardian?

Yes

Will your spouse name the same person as guardian?

Yes

Would you like to name an alternate guardian?

Yes

Will your spouse name the same person as alternate guardian?

Yes

Durable Power of Attorney - Who Handles Finances if You're Unable

Would you like to name a power of attorney?

Yes

Will your spouse name the same person as power of attorney?

Yes

Would you like to name an alternate power of attorney?

Yes

Will your spouse name the same person as alternate power of attorney?

Yes

Health Care Agent - Who Makes Medical Decisions if You Can't

Would you like to name a health care agent?

Yes

Will your spouse name the same person as health care agent?

Yes

Would you like to name an alternate health care agent?

Yes

Will your spouse name the same person as alternate health care agent?

Yes

Assets Overview

You do not need to complete this section unless you already know the approximate value and ownership of your major assets. Estimates are fine - exact figures aren't necessary.

Do you own any real estate? (Home, rental property, land, etc.) If yes, please fill out the value and ownership info below.

Yes

Estimated total value of all real estate:

Loan balance (if any)

Who owns the property?

You

Spouse

Joint

In Trust

Mix

Unsure

Do you own any vehicles, boats, or RVs? If yes, please fill out the value and ownership info below.

Yes

Estimated total value of all vehicles, boats, or RVs:

Loan balance (if any)

How is it titled?

You

Spouse

Joint

In Trust

Mix

Unsure

Do you have any bank accounts (checking, savings, CDs, etc.)? If yes, please fill out the value and ownership info below.

Yes

Estimated total value of all bank accounts:

How is it titled?

You

Spouse

Joint

In Trust

Mix

Unsure

Do you have any IRAs, 401(k)s, or similar retirement accounts? If yes, please fill out the value and ownership info below.

Yes

Estimated total value of all retirement accounts:

How is it titled?

You

Spouse

Joint

In Trust

Mix

Unsure

Do you have any investment accounts, stocks, or bonds (outside of retirement)? If yes, please fill out the value and ownership info below.

Yes

Estimated total value of all investments:

How is it titled?

You

Spouse

Mix

Unsure

Do you have any life insurance or annuities?

Yes

Estimated total face value:

Have you named beneficiaries?

Yes

Unsure