Short Form RLT - CDQ : Estate Planning - ITS Alliance Partners, LLC

Data Entry / LWT & POA Package

TIMED-PAGE NOTICE

Entry fields with a red asterisk (*) are minimally required for page submission.

*Access Code:

1) CREATOR / SPOUSE PERSONAL INFORMATION

Creator:

Yes

*First Name

*Last Name

DOB

U.S. Citizen

Spouse:

Yes

First Name

Last Name

DOB

U.S. Citizen

Address:

*Street Address (or P.O. Box No.)

Unit

*City

*County/Parish

*State

*Zip Code

Contact:

*Daytime Phone

Other Phone

*E-mail Address

2) BENEFICIARIES OF YOUR WILL

				Male
First Name	MI	Last Name	DOB	Female	Relationship	Share

				Male
First Name	MI	Last Name	DOB	Female	Relationship	Share

				Male
First Name	MI	Last Name	DOB	Female	Relationship	Share

				Male
First Name	MI	Last Name	DOB	Female	Relationship	Share

				Male
First Name	MI	Last Name	DOB	Female	Relationship	Share

				Male
First Name	MI	Last Name	DOB	Female	Relationship	Share

				Male
First Name	MI	Last Name	DOB	Female	Relationship	Share

3) DISTRIBUTIONS TO CONTINGENT BENEFICIARIES

Select the appropriate provision designating to whom the share of any Primary Beneficiary (PB) - as are identified above - who may not survive you shall be distributed to as a Contingent Beneficiary(s).

	EQUALLY to PB's surviving children - or, if PB leaves no surviving children, then equally to PB's surviving siblings (or to remaining Primary Beneficiaries).
	EQUALLY to PB's surviving siblings (or to remaining Primary Beneficiaries) - or, if PB leaves no surviving siblings (no remaining Primary Beneficiaries), then equally to PB's surviving children.

4) ADMINISTRATORS OF YOUR WILL & POA

For marital co-creators, your spouse shall be listed as the first appointee administrator.

Successor Trustee(s):

1)
	First Name	Initial	Last Name	Relationship

2)
	First Name	Initial	Last Name	Relationship

Financial POA Agent(s):

1)
	First Name	Initial	Last Name	Relationship

2)
	First Name	Initial	Last Name	Relationship

Last Will Executor(s):

1)
	First Name	Initial	Last Name	Relationship

2)
	First Name	Initial	Last Name	Relationship

5) GUARDIAN APPOINTEES FOR DEPENDENTS

1)				/
	First Name	Initial	Last Name		Relationship

2)				/
	First Name	Initial	Last Name		Relationship

DISINHERITED FAMILY MEMBERS (IF ANY)

NOTICE TO PURCHASER: Identify only any bloodline descendants and/or legally adopted children and/or their descendants who are to be disinherited from your Will.

Creator's Disinherited Family Members:

(250 Original Characters Available)

Spouse's Disinherited Family Members:

(250 Original Characters Available)

SPECIFIC WILL DIRECTIVES

NOTICE TO PURCHASER: Entries in the "Specific Will Directives" textbox below will (a) modify, (b) add to, and/or (c) rescind certain general terms and decrees commonly used in conjunction with "default" estate administration and distribution language. It is recommended that you (eventually) obtain legal counsel to advise you as to the application and meaning of any personalized text that you may enter in the Specific Will Directives textbox. (As a current MLCP Subscription Member, you will be able to edit/modify your personal data and/or Specific Will Directives entries at any time and as many times as you wish, and to correspondingly [re]print portions or all of your auto-regenerated document set with no limitations or additional costs to implement your changes).

Creator's Specific Directives:

(800 Original Characters Available)

Spouse's Specific Directives:

(800 Original Characters Available)

NOTES / COMMENTS / QUESTIONS

NOTICE TO PURCHASER: Entries in the "Notes/Comments/Questions" textbox below will be auto-posted and permanently recorded in your (forthcoming) Client Console's NotePad Message Center. Archived NotePad message entries can be made available, by your choosing, for viewing and additional text entry applications by your legal counsel and/or other select persons.

Make Your MLCP Will & DPOA Order Here

Notice: Access Code entry is required (top of page)
in order to view Contract & Purchase Agreement

I/(We), the person(s) identified above as the Client (& Spouse) for the purposes of this transaction, now elect to purchase the My LifeCard Plan (MLCP) Will & DPOA Package for the amount of the Placement and Membership Fees as defined in the Contract & Purchase Agreement linked hereunder. NOTE > You must click on the button below to view the Contract and Purchase Agreement and then the "I AGREE" button at the bottom of the Contract page:

Credit Card

Debit Card

(or)

TRY BEFORE YOU BUY

Bank Card No.

Card Verification No.

Exp. Date

Billing:


Card/Account Name		Street Address

City

State

Zip Code

By submitting this My LifeCard Plan^® Will & DPOA Package Data Questionnaire, I/We, identified as the person(s) whose name(s) has/have been entered above, hereby attest and confirm that I/We have read the Contract & Purchase Agreement and fully understand and agree with all the terms and conditions prescribed therein and that its execution - by virtue of the submitting of this transaction / by activating the "Submit/Process" button - is an acceptance by me/us of all of its mutually protective covenants, terms and conditions, and agree that said Contract/Agreement is lawfully binding upon all parties identified therein.