Eash Law, P.C.

114 South Main Street
Middlebury, IN 46540

(574) 825-9665

Thank you for taking the time to fill out our Estate Planning Form at Eash Law, P.C. Please fill out the information below to the best of your ability as it will help us expedite our time for in person consultations. If you are confused with any questions presented, simply leave it blank and we will discuss in person or feel free to call our office. Looking forward to meeting you soon!

Brendon Eash

Attorney at Law

Eash Law, P.C.

114 S. Main St.

Middlebury, IN 46540

(574) 825-9665

beash@eashlaw.us

Contact information: Your Information

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Upon submission, a copy of this form will be sent to the primary email.

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What is the full name of your spouse? (If applicable)

What is your spouse’s date of birth?

Please list the full name of the individuals who you want to be a beneficiary of your estate? (For each person you list, include their full name, date of birth, and relationship to you.)

Do you want the proceeds of your estate split evenly between your children or beneficiaries?

Yes

If you are not distributing your estate evenly among your beneficiaries or heirs, how do you want your estate distributed?

Please list the address of any and all property you own along with an estimated value.

Please list all checking, savings, 401K, IRA accounts, or any other checking or savings account you have and an estimated value as of today’s date.

Please list any life insurance policies you have and who the beneficiaries are as of today’s date.

Please list any items you may own which have a value of $100,000.00 or more. (If you have any property you expect to receive prior to your death, such as inheritance from your parents, or any item that will appreciate in value i.e. a classic car)

Please upload a copy of your most recent tax bill for all properties you currently own.

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Please include any additional information you would like us to know about the assets in your estate or any other information you feel might be pertinent our upcoming consultation.