FORMS

PRIVILEGED – ATTORNEY WORK PRODUCT AND ATTORNEY-CLIENT COMMUNICATION

ASSET FORM 1

Name

Address

City ST Zip

email phone

~ VALUES ~

Assets: Mine

Yours

Ours

Residences

Other RE

Stocks

Bonds

Cash

Mortgages

Insurance

Tangibles

Retirement

Trusts

Other

TOTAL:

Debts:

Mortgage

Other

TOTAL:

Have you executed a Power of Attorney? Yes No

Have you executed a Health Care Proxy? Yes No

Do you wish to be an organ donor and tissue donor? Yes No

If yes, have you signed an organ donor card or indicated on your driver's license? Yes No

Have you told your family your intentions to be an organ donor? Yes No

Are you named as a defendant in any court action? Are you likely to be named as one?

Yes No

select the link below to print and send via mail

In addition, please mail or bring in the following to your appointment:

a. A copy of your deed to all real estate in which you have interest.

b. A copy of your current will(s), health care proxy, power of attorney, etc.

c. A copy of any and all life insurance policies that you own or insure your life (please include beneficiary designations.

d. A copy of any and all disability insurance policies.

e. A copy of all bank, brokerage, retirement and any other accounts in your name – to

verify titling of assets.

f. A copy of any shareholder agreements that involve your closely held stock.

g. A copy of your marriage license, domestic partnership certificate, separation or

divorce agreements that you may have executed, and/or divorce decree.

h. A copy of any adoption papers that you executed or the name, address and

telephone number of the attorney who is handling adoption matters for you.

Asset Form (to print)

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click for a free download.

offices located at:

560 White Plains Road Suite 530 Tarrytown, NY 10591
1-914-366-4842 1-914-846-0161 fax

845 3rd Avenue 6th Floor New York, NY 10022

1-646-290-5168

email

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