About this form
Thank you for instructing Ellsworth Dane & Co. This questionnaire gathers the information your attorney needs to advise you and to prepare your North Carolina estate planning documents — typically your Last Will and Testament, a Durable Power of Attorney, a Health Care Power of Attorney, and an Advance Directive for a Natural Death (living will), together with any trust your plan calls for. It usually takes 20 to 30 minutes to complete in full, though you can save your progress and return to it at any time before submitting.
Before you begin
It will save time if you have the following to hand:
- Your personal details — your full legal name, date of birth, and the North Carolina county where you live
- Your spouse or partner's details, if this applies to you — their full legal name and date of birth
- Details for each of your children — full legal name, date of birth, and whether they are biological, adopted, or a stepchild
- The people you would like to serve in key roles — your executor (in North Carolina, the personal representative), a guardian for any minor children, your financial agent, and your health care agent — together with a backup for each
- A general picture of what you own — approximate values for any bank, brokerage, and retirement accounts, life insurance, and business interests, plus details of any real estate you own (including property outside North Carolina)
- Records of any significant debts, such as mortgages and loans
- Details of any existing will, power of attorney, or health care directive, including roughly when it was signed and where it is kept
You will not need to upload these documents through this form. The questionnaire asks for the key figures and details only; your attorney will request supporting documents directly where needed.
A few things to keep in mind as you fill it in:
Answer as fully and accurately as you can. Your attorney will rely on the information here when advising you and preparing your Will, your Powers of Attorney, and your health care directives, along with any trust. Accurate information about your family, your assets, and your wishes is essential to an estate plan that is valid and does what you intend; incomplete or inaccurate information can lead to documents that miss your goals, or that are harder for your family to administer later.
If you are unsure about a figure or a date, give your best estimate and flag it in the relevant field. We can refine it together at our next meeting.
If a question does not apply to your circumstances, note "N/A" rather than leaving it blank, so we know you have considered it.
Where the form asks about choices you have already thought through — such as who should inherit, or who should serve as your executor, guardian, or agents — please describe your current thinking. If anything is not yet settled, tell us; part of our role is to help you weigh those decisions and put them into effect properly.
Confidentiality and privilege
The information you provide through this form is confidential and is intended to be protected by the attorney-client privilege and the attorney work-product doctrine. Please complete the form on a private device and avoid forwarding your responses to third parties, as doing so may waive privilege.
A note on representation
If you are married or planning alongside a partner and you have both asked us to prepare your estate plans, we may represent you jointly. Joint representation means that, as between the two of you, there are no secrets from one another: information one of you shares with us that is relevant to the plan may be shared with the other. If a conflict arises between you that we cannot properly manage, we may need to withdraw from representing one or both of you. If you would each prefer separate, independent representation, let us know and we will discuss the options with you. If you are planning on your own, we represent you alone.
A note on engagement
Submitting this form does not by itself create an attorney-client relationship. We will confirm our engagement in writing following a conflict check and execution of our engagement letter. If you have any concerns in the meantime about the timing or urgency of your matter, please contact our office directly.
Questions while completing the form
If anything is unclear, please contact your attorney's assistant at Ellsworth Dane & Co before guessing. It is far easier to clarify a question now than to correct an answer later.
