As we work with you to create a plan that accomplishes all of your objectives, we consider three interrelated topics:

Preserving & Growing Your Financial Wealth. This element provides financial security for you and for the people and causes that are important to you

Your Estate Plan. Your estate plan protects your financial assets during your lifetime and directs how they will pass when you are gone. A proper plan will protect those assets from the major risks that can destroy them: probate court, taxes, divorce, lawsuits, and financial immaturity.

Preserving & Sharing Your Non-Financial Wealth. This is the part of your plan that protects the values, stories, traditions and life lessons that matter and assists you in passing them on to younger generation family members in ways that will empower them to live happier and more fulfilled lives.

We understand that many of these questions may be sensitive and personal. Some of these questions may raise issues that are of no interest to you. Please do not feel an obligation to answer any of these questions. You are in control of this conversation.

This Assessment is critical to us in learning what is and is not important to you. We have tools and strategies that can be very beneficial in helping you achieve the outcomes that are important to you, and these questions point us to those solutions. We want to be as useful as you want us to be.

First Name

Last Name

Email (primary) *

FINANCIAL QUESTIONS

1. Will you (and the people who rely on you) have the financial resources they need to maintain their lifestyle if you become incapacitated?

Yes

No

2. Will the people who rely on you have the financial resources they need to maintain their lifestyle in the event you die?

Yes

No

3. If you have children or grandchildren depending on you to pay for college... is their college funding secure?

Yes

No

4. Are you confident you are on track to have (or maintain) your desired level of income in retirement?

Yes

No

5. If your estate is large enough to be subject to the Federal or State estate tax... do you have the resources to pay that tax without selling your family home, business, farm or other property?

Yes

No

6. Are you confident you have adequate resources to pay for the cost of health care and long term care without depleting your asset base?

Decided

Undecided

7. Do you have umbrella insurance to protect you and pay your legal fees if you are sued? Y

Yes

No

8. Is it important to you to leave a financial inheritance to your heirs or charity when you pass?

Yes

No

BUSINESS OR PROFESSIONAL PRACTICE

9. If there are owners in addition to you... Do you have a buy-sell agreement that is triggered by the retirement, incapacity or death of a partner or shareholder?

Decided

Undecided

10. Do you have a management succession plan that ensures the preservation of the value of your farm, business or professional practice in the event of your incapacity or death?

Yes

No

11. If you have business debt... Do you have a strategy in place that will ensure that debt is paid in the event of your death?

Yes

No

12. Do you have an exit plan?

Decided

Undecided

FAMILY LEGACY

13. Do you have an heir that has or may have addictive behavior patterns related to alcohol, drugs or another self- destructive behavior?

Yes

No

14. Do you have an heir who, even as an adult, has not yet developed the skill and maturity to solely manage his or her inheritance?

Yes

No

15. Do you have an heir who is subject to the undue influence of another (such as a spouse, friend(s), or relative) that could result in your heir losing the inheritance he or she receives from you?

Sure

Unsure

16. Do you have an heir who has special needs or limitations associated with a physical or developmental diagnosis (such as Down Syndrome or Cerebral Palsy)?

Yes

No

17. Are there areas of tension between family members that cause hurt feelings or arguments at times?

Yes

No

18. If you become incapacitated or pass away, are these tensions likely to cause permanent rifts in an already difficult situation?

Sure

Unsure

19. Would you like to resolve conflicts now to preserve your long-term family structure and relationship?

Yes

No

ESTATE PLANNING AND RISK

20. Are your assets currently protected from judgment creditors if you are sued by someone?

Yes

No

21. Will your current plan avoid the need for a probate court proceeding if you became incapacitated?

Known

Unknown

22. Will your estate require a probate proceeding at your death?

Yes

No

23. In your current plan, will the assets you leave your spouse be protected if he/ she remarries?

Yes

No

24. In your current plan, will the inheritance passing to your heirs be protected in the event they divorce, go bankrupt or have a legal judgment entered against them?

Known

Unknown

25. Do you have an heir that is not yet fully capable of responsibly managing their inheritance?

Yes

No

26. Will your estate be subject to a federal or state estate or inheritance tax?

Yes

No

27. Do you have appreciated assets that would create a significant capital gains tax if you sold them?

Known

Unknown

28. In your current plan, will you be able to pay for the cost of long-term care without having to sell and spend your assets?

Yes

No

29. Do you have current health care decision documents in place?

Yes

No

YOUR FAMILY LEGACY

30. Do you have a fairly clear idea of the impact you want the inheritance you leave to have on your heirs?

Decided

Undecided

31. Assuming you passed fairly soon, do you have an heir who could potentially be impacted negatively by the financial inheritance they will receive from you?

Yes

No

32. Have you planned your funeral?

Yes

No

33. Do you have wisdom or life lessons you would like to have shared with family and friends at your funeral?

Decided

Undecided

34. Would you like for your funeral to be a teaching moment?

Yes

No

35. Can you think of specific traditions that help keep your family connected?

Yes

No

36. Would you like to explore ways to preserve and pass on those traditions?

Decided

Undecided

37. Do you have photographs, film or other artifacts that need to be organized and preserved before they disintegrate?

Yes

No

38. Do you have artifacts you can connect to specific stories or values that matter to you?

Yes

No

39. Do you have specific artifacts you want to pass to a particular person?

Sure

Unsure

40. Is sharing travel experiences with your family something that has been important to you?

Yes

No

41. Have you preserved your travel experiences in photographs, videos or travel books that are accessible to the people who shared those experiences with you?

Yes

No

42. Are there stories or experiences either your own or of friends or family that impacted your own values which you would like to preserve and share?

Sure

Unsure

43. Is sharing values, wisdom and life lessons with younger generation family members something that is important to you now?

Yes

No

44. Can you think of a word or a few words you would use to describe your family to others?

Yes

No

45. Are there symbols or designs that could be used if you created a family logo or crest?

Sure

Unsure

46. Are the younger generation family members aware of the family brand?

Yes

No