Hishaw Law, LL.C. - Metlife-Wyoming - Questionnaire

Welcome and Registration
Please use your legal name as it appears on your license or government-issue ID

Welcome MetLife Legal Plan Member! Start your estate plan quickly and securely from home. Simply click “Start,” answer a few questions (about 10 minutes), and our office will contact you to schedule your covered attorney consultation. You’ll also receive a login to update your information anytime. Enjoy a fast, convenient, and secure way to complete your estate plan with your MetLife Legal Plan benefit.

First Name *

Middle Name

Last Name *

Email *

Password *

Phone Number *

Metlife Information
MetLife requires a EID for each document we prepare for you.

(EID) Employee Identification Number *

Metlife Member Name *

Your Contact Details
Your Contact Details

Name:

Date Of Birth *

Also known as (optional)

Suffix (optional)

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Jr

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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 Contact Details Continued
Your Contact Details

Name:

Are you married? *

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Yes

✓

No

Please select "Are you married?".

Suffix (optional)

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Jr

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Sr

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II

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III

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Other

Please Name your parents (First & Last Name)

Full Name your mother:

Full Name your Father:

Your Spouse Information
Please use your legal name as it appears on your license or government-issue ID

Your spouse's Details

First Name: *

Middle Name

Last Name: *

Email *

Date Of Birth *

Phone Number *

Suffix (optional)

✓

Jr

✓

Sr

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II

✓

III

✓

Other

Also known as (optional)

What is your spouse's gender? *

✓

Male

✓

Female

Please select "What is your spouse's gender?".

Is Your spouse's address different than you? *

✓

Yes

✓

No

State:

Estate Valuation
The value of your estate is the combined value of all your assets.

What is the value of your estate? *

Do you own real estate outside of the North Carolina? *

✓

Yes

✓

No

Children and Beneficiaries
If Yes If you have Children, you will be provided with the option to establish a Testamentary trust for your children. If No If you do not have children and you do not have a spouse, you can name beneficiaries.

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

✓

Yes

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No

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

Beneficiary Information

Please note: If you are married, this estate planning tool is designed to leave your estate to your spouse by default. The distribution of property you specify in this section will only take effect if your spouse passes away before you. This section allows you to name a secondary beneficiary who will receive your assets through your Last Will and Testament in the event your spouse is no longer living at the time of your death.

Primary Beneficiary * Click the "+" button to add another individual.

Relationship Type:

Address: *

Phone Number *

Email *

How Do You Wish To Distribute Your Estate To Your Beneficiaries? *

Split shares equally to all Beneficiaries Split shares as Follows

Percentage(%)

Note: If the beneficiaries should predecease you then their share will be distributed to their descendants

Children
Select the options that apply to you. For children under 18, you will be required to select a guardian and trustee. If your children are over 18 or you do not wish to leave a trust, then you your children will receive your estate outright.

Select all that apply regarding your children, if any

I have children who are under 18 *

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Yes

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No

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

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Yes

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No

I have children with special needs *

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Yes

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No

Guardians for Your Minor Children
Guardian is a person who takes care of the physicall needs of your child, when both the applicant and/or applicant and spouse until they turn 18. If you have step children, then the surviving bioligical parent is presumed to be guardian, unless their rights have been legally teminated. You can overwrite primary Guardian

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

For married your spouse is automatically named as the Guardian.

Primary Guardian * Click the "+" button to add another guardian

Relation Click the "+" button to add another guardian

Children Information
Name your children and/or step children. Determine how to distribution your estate and when you would distributed.

Add all your children that you and/or your spouse/partner have and include their full name with middle initial.

Child’s Name *

Date of Birth *

Parents of Child *

How do you wish to distribute your estate to your children?

✓

Split shares equally

✓

Split shares as Follows

Percentage(%)

Children

A lump sum at age of

Executor
The Executor is the person who administers the estate. Its common to have the same person be the Executor and Trustee" our Spouse will be your default Executor. You can name an alternative trustee should you spouse or primary trustee not survive and you can overwrite primary Executor.

Please list individuals to serve as the Personal Representative of your Last Will and Testament. If possible, we recommend naming more then one alternate representative as well.

Primary Executor: *

Relation

Address:

Phone:

Email:

Alternative Executor:

Relation:

Address:

Phone:

Email:

Alternative Executor: * Click the "+" button to add another successor

Relation:

Address:

Phone:

Email: *

Executor - Spouse/Partner
The Executor is the person who administers the estate. Its common to have the same person be the Executor and Trustee" our Spouse will be your default Executor. You can name an alternative trustee should you spouse or primary trustee not survive and you can overwrite primary Executor.

Please list individuals to serve as the Personal Representative of your Last Will and Testament. If possible, we recommend naming more then one alternate representative as well.

Primary Executor: *

Relation

Address:

Phone:

Email:

Alternative Executor: Click the "+" button to add another successor

Relation:

Address:

Phone:

Email:

Alternative Executor: *

Relation:

Address:

Phone:

Email: *

Financial DPOA:
Name someone (agents) you trust to make financial decisions on your behalf in the event you are unable to do so yourself.

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

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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 *

Financial DPOA-Spouse/Partner
Name someone (agents) you trust to make financial decisions on your behalf in the event you are unable to do so yourself.

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
Name someone (agents) to make medical decisions on your behalf in the event that you are unable to make those decisions for yourself

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

Do you wish to use the same agents as your Executor *

✓

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
Name someone (agents) to make medical decisions on your behalf in the event that you are unable to make those decisions for yourself

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 *

HIPAA Agents
Under federal law, the Health Insurance Portability and Accountability Act (HIPAA) prohibits your medical providers from disclosing your medical information to anyone other than you or individuals you have specifically authorized.

Please provide the information of one or more individuals who will serve as your hipaa agent:

Do you wish to use the same agents as your Medical Health Care Power of Attorney? *

✓

Yes

✓

No

Primary Agent : Full Legal Name: *

Phone Number

Address

Alternative Agent *

Phone

Address

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

Phone *

Address *

HIPAA Agents Spouse/Partner
Under federal law, the Health Insurance Portability and Accountability Act (HIPAA) prohibits your medical providers from disclosing your medical information to anyone other than you or individuals you have specifically authorized.

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

Do you wish to use the same agents as your Medical Health Care Power of Attorney? *

✓

Yes

✓

No

Primary Agent : Full Legal Name: *

Phone Number

Address

Alternative Agent *

Phone

Address

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

Phone *

Address *

Summary

Click the “Submit” button below to proceed and get your selected estate planning documents. Your information will be sent to our office, and you’ll be contacted to schedule a meeting with a legal professional to review your documents.

Before you submit this application, please answer the question below

Select your End of Life Instructions?

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Please note I wish to be cremated

✓

Please note I wish to be buried

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