HISHAW LAW LLC.

Metlife - Registration Info

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First Name *

Middle Name

Last Name *

Email *

Password *

Cell *

Your Contact Details

Name:

Date Of Birth *

Also known as (optional)

Suffix (optional)

✓

Jr

✓

Sr

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II

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III

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Other

Select your gender?

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Male

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Female

Your Address

Full Address: *

State

Your Spouse Information

Your spouse's Details

First Name: *

Middle Name

Last Name: *

Email *

Date Of Birth *

Phone Number *

Suffix(optional)

✓

Jr

✓

Sr

✓

II

✓

III

✓

Other

Also known as(optional)

What are your spouse's pronouns?

✓

he/him

✓

she/her

✓

they/them

Is Your spouse's address different than you? *

✓

Yes

✓

No

State:

Metlife

(EID) Employee Identification Number *

Metlife Member Name *

Children and Beneficiaries

Are you a parent or legal guardian of a child? *

✓

Yes

✓

No

Please select "Are you a parent or legal guardian of a child?".

Children

Select all that apply regarding your children, if any

I have children who are under 18 *

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Yes

✓

No

I plan on having a trust for some or all of my children *

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Yes

✓

No

I have children with special needs *

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Yes

✓

No

Guardians for Your Minor Children

If Single, name your guardians, if married and your spouse predeceases, then please provide the names of the persons you would like to be your Guardian

Name who you wish to be legal guardian(s) for your minor children:

(Hit 'add' to include their additional guardians)

Primary Guardian *

Children Information

How many children do you and/or your spouse/partner have?

Child’s Name *

Child Age *

Parents of Child *

Select your child/children's age to distribute the principal trust

A lump sum at age of *

Trustee

Provide the legal name of your trustee to administer the trust that will be created for your beneficiaries:

Would you like your Primary Trustees to serve jointly? *

✓

Yes

✓

No

Primary Trustee: *

Serve Jointly

Financial DPOA-Spouse/Partner

Provide the information of individuals who will serve as your agent under the Durable Power of Attorney:

Do you want to use the same agents as your personal representative? *

✓

Yes

✓

No

Primary Agent: *

Phone Number *

Email Address *

Alternative Agent *

Phone Number *

Email Address *

Alternative Agent * Click the "+" button to add another agent

Phone Number *

Email Address *

Health Care POA

Please provide the information of individuals who will serve as your health care agent:

Do you wish to use the same agents as your Financial Durable Power of Attorney *

✓

Yes

✓

No

Primary Agent: *

Phone Number *

Address

Alternative Agent: *

Phone Number *

Address *

Alternative Agent: * Click the "+" button to add another agent

Phone Number *

Address *

Health Care POA - Spouse/Partner

Please provide the information of individuals who will serve as your health care agent:

Do you wish to use the same agents as your Financial Durable Power of Attorney *

✓

Yes

✓

No

Primary Agent: *

Phone Number *

Address

Alternative Agent: *

Phone Number *

Address *

Alternative Agent: * Click the "+" button to add another agent

Phone Number *

Address *

Summary

If you would like to review your responses, please review your responses on the right hand side on the specific screens. After you click submit, you will be finished and we will email your answer and the office will contact you with the next steps .

Your Progress