Kevin C. Martin Attorney at Law, PLLC

Legal Services Plan Registration

Please enter your full legal name and your legal plan member information exactly as it appears in your benefits records. This information helps us verify eligibility and complete your documents accurately.

First Name *

Middle Name

Last Name *

Email *

Password *

Cell *

Your Contact Details

Name:

Date Of Birth *

Also known as (optional)

Are you married? *

✓

Yes

✓

No

Please select "Are you married?".

Suffix (optional)

✓

Jr

✓

Sr

✓

II

✓

III

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Other

Select Your Gender?

✓

Male

✓

Female

Your Address

Full Address: *

Address Line

Apartment or Suit Number

City

State

Zip Code

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)

Spouse gender?

✓

Male

✓

Female

Is your spouse’s address different from yours?

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Yes

✓

No

State:

Plan Provider Selection

Which legal plan provider do you have? *

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MetLife

✓

ARAG

Please select "Which legal plan provider do you have?".

Beneficiary, Children, & Trust

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

A guardian cares for your child’s physical needs if you (and your spouse, if applicable) pass away before the child turns 18. For stepchildren, the surviving biological parent remains guardian unless their rights were legally terminated.

Name your preferred legal guardian(s) for your minor children. If single, list your guardians; if married and your spouse predeceases you, list who you would want as guardian(s).

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

Children Information

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

Child’s Name *

Child Age *

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

Please name at least one or more individuals who will serve as the Personal Representative of your last will & testament:

Primary Executor * Click the "+" button to add another agent

Executor - Spouse/Partner

Primary Executor *

Financial DPOA:

Provide the information of one or more 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: * Click the "+" button to add another agent

Phone Number *

Address *

Financial DPOA-Spouse/Partner

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

Phone Number *

Address *

Health Care POA

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

Do you wish to use the same agents as your Financial Durable POA? *

✓

Yes

✓

No

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

Phone Number *

Address *

Health Care POA - Spouse/Partner

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

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

✓

Yes

✓

No

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

Phone Number *

Address *

Submission Screen

You can review your responses on the right-hand side of each screen before submitting. After you click Submit, you’ll be all set! We’ll send you an email with your answers, and the office will reach out with the next steps.

Your Progress