Trust Packages
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FAQ
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Trust Packages
About
FAQ
Contact

Your Information

First Name *

Last Name *

Email *

Phone *

Date Of Birth *

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Financial Power of Attorney

PRIMARY AGENT - Full Legal Name *

PRIMARY AGENT - Phone Number *

PRIMARY AGENT - Address *

PRIMARY AGENT - Relationship to You *

Want to name a backup (successor) agent? *

Yes

No

SUCCESSOR AGENT - Full Legal Name

SUCCESSOR AGENT - Relationship

SUCCESSOR AGENT - Phone

SUCCESSOR AGENT - Address

Grant ALL general financial powers? *

Select an option

Yes (recommended)
No (customize)
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Healthcare Directive

Same agents as Financial POA above? *

Select a option

Yes - same
No - different
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HEALTHCARE AGENT - Full Legal Name

HEALTHCARE AGENT - Relationship

HEALTHCARE AGENT - Address

HEALTHCARE AGENT - Phone

ALTERNATE AGENT - Full Legal Name

ALTERNATE AGENT - Phone

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Healthcare Wishes

End-of-life decision (incurable/unconscious) *

Select an option

Do not prolong
Prolong life
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Pain Relief Preference *

Select an option

Yes always
I have limitations
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Pain relief exceptions (if any)

Donate organs upon death? *

Select an option

Yes
No
Already registered
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If donating, for what purposes?

Transplant

Therapy

Research

Education

Any

Additional healthcare wishes

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About you

Marital status

Select a option

Single
Married
Domestic
Divorced
Widowed
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Spouse/partner's full name (if applicable)

Do you have minor children (under 18)?

Select an option

Yes
No
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How many minor children?

Do you own real estate?

Select a option

Yes
No
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Property address (if yes)

Approximate total estate value?

Enter an option

Under $50K
$50-184K
$184-500K
Over $500K
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Do you currently have a Trust?

Enter an option

Yes
No
Not sure
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Do you currently have a Will?

Enter an option

Yes
No
Not sure
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Confirmation

Please confirm (all 3 required): *

Info is accurate

Understand it's not legal advice

Understand 2-day turnaround

How did you hear about us?

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Google
Facebook
Instagram
Referral
Advisor
Event
Other
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NEXT

Redding Trust & Insurance Co.

Legal Document Assistant #LDA082

California Insurance License #4384531

(530) 377-6884

We offer legal document preparation services, not legal advice. If you need legal advice, please consult with an attorney.

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