Metaverse Justice Group

Welcome To The Metaverse Justice Group
Please use your legal name as it appears on your license or government-issue ID

Thank you for placing your trust in our firm during this difficult time. We know that handling probate matters can feel overwhelming, and our team is here to make the process as clear and manageable as possible.
Please complete this secure intake form so we can gather the information needed to assist you efficiently. The form should take about 15–20 minutes, and you may save your progress and return whenever it is convenient.
After submission, we will carefully review your information and follow up with the next steps.
Let’s begin with your information below.

First Name *

Middle Name

Last Name *

Email *

Password *

Telephone *

Full Address *

RELATIONSHIP TO DECEASED (Who is filling out this form?): *

Estate Planning Questionnaire

Intake date

Please use “n/a” to indicate not applicable.

Client One Information (Applicant Information)
Need Help with Personal Information?
• Date of Birth: Enter your date of birth exactly as it appears on your official documents.
• Also Known As (optional): Include any nickname or alternative name you use legally or professionally.
• Marital Status: Select the option that accurately reflects your current legal marital status.
• Suffix: Include if applicable (e.g., Jr., Sr., III).
• Personal Pronouns: Enter your preferred pronouns.
• Address: Use your current legal residential address.
• If you run into any issues or problems, reach out to our team for assistance at (214) 831-8831 or email support@legalgen.com.

Any other name(s) used:

Date of Birth:

Social Security Number:

Place of Birth:

Are you a United States citizen?

✓

Yes

✓

No

Permanent residence:

Own or rent?

How long have you resided there?

Other residence(s):

Other residence(s): Own or rent?

Home telephone number:

Business telephone number:

Fax:

If you have residences in more than one state:

✓

Yes

✓

No

Are you married? *

✓

Yes

✓

No

Please select "Are you married?".

Gender *

✓

Male

✓

Female

Client Two Information (Spouse Information)
Need Help with Personal Information?
• Date of Birth: Enter your date of birth exactly as it appears on your official documents.
• Also Known As (optional): Include any nickname or alternative name you use legally or professionally.
• Marital Status: Select the option that accurately reflects your current legal marital status.
• Suffix: Include if applicable (e.g., Jr., Sr., III).
• Personal Pronouns: Enter your preferred pronouns.
• Address: Use your current legal residential address.
• If you run into any issues or problems, reach out to our team for assistance at (214) 831-8831 or email support@legalgen.com.

Spouse Legal First Name

Spouse Legal Middle Name

Spouse Legal Last Name

Email

Any other name(s) used:

Date of Birth:

Social Security Number:

Place of Birth:

Are you a United States citizen?

✓

Yes

✓

No

Home Address: (Full Adress)

Home Phone:

Cell Phone:

Gender *

✓

Male

✓

Female

Children Information
Need Help?
• Enter the names of your children and/or stepchildren.
• Specify how you would like your estate distributed and the timing of each distribution.
• Providing accurate information ensures your estate plan reflects your wishes.
• If you encounter any issues or problems, contact our team at (214) 831-8831 or email support@legalgen.com.

Enter the total number of children and stepchildren you and/or your spouse/partner have. This information will be used to guide how your estate is distributed among your children.

Full Legal Name: * add more child

Date of Birth *

Parent(s) *

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

Planning Objectives/Family Values
Planning Objectives/Family Values

From predators who can discover inheritance amounts and target young/vulnerable beneficiaries

Client One (Applicant)

Client Two (Spouse)

From claims of divorced spouses to take half of your child or beneficiary’s inheritance

Client One (Applicant)

Client Two (Spouse)

From malpractice claims, for beneficiaries with a professional practice

Client One (Applicant)

Client Two (Spouse)

From other creditors’ claims (such as car accident)

Client One (Applicant)

Client Two (Spouse)

From the stress and delays of the average 9 to 16 month process of probate

Client One (Applicant)

Client Two (Spouse)

From the financial immaturity resulting in a quick loss of an inheritance

Client One (Applicant)

Client Two (Spouse)

From sharing assets with heirs you would rather disinherit

Client One (Applicant)

Client Two (Spouse)

From litigation claims by disinherited heirs

Client One (Applicant)

Client Two (Spouse)

For parents only: from relatives who would be poor, abusive or even dangerous guardians or from foster care

Client One (Applicant)

Client Two (Spouse)

For parents only: from acquaintances and relatives who should not be allowed to be alone with your children

Client One (Applicant)

Client Two (Spouse)

For special needs beneficiary only: from neglect in the government care system

Client One (Applicant)

Client Two (Spouse)

Planning Objectives/Family Values (PRESERVE AND MAXIMIZE ASSETS)
Planning Objectives/Family Values

By minimizing taxes during your life (income taxes, capital gains taxes, estate taxes on inheritances you expect to receive)

Client One (Applicant)

Client Two (Spouse)

By minimizing or eliminating estate taxes upon your death (up to 55% of your assets and life insurance benefits)

Client One (Applicant)

Client Two (Spouse)

By reducing estate administration costs through probate avoidance

Client One (Applicant)

Client Two (Spouse)

Ensure that a special needs beneficiary has assets that are protected from government seizure while retaining eligibility for needed services

Client One (Applicant)

Client Two (Spouse)

Ensure that your family has enough life insurance to provide a comfortable lifestyle

Client One (Applicant)

Client Two (Spouse)

By ensuring that your assets are passed to your descendants and not given away to outsiders, such as spouses, creditors or the government

Client One (Applicant)

Client Two (Spouse)

Planning Objectives/Family Values (PROTECT YOURSELF AND YOUR SPOUSE)
Planning Objectives/Family Values

From malpractice or other creditor claims

Client One (Applicant)

Client Two (Spouse)

From conservatorship proceedings (aka “living probate”) if you become incapacitated

Client One (Applicant)

Client Two (Spouse)

From probate delays and stress upon your death or the death of your partner

Client One (Applicant)

Client Two (Spouse)

From hospital policies requiring life sustaining procedures when you would rather not endure them

Client One (Applicant)

Client Two (Spouse)

From healthcare decisions made by people other than those you trust most

Client One (Applicant)

Client Two (Spouse)

Planning Objectives/Family Values (TAKING CHARGE OF YOUR LIFE)
Planning Objectives/Family Values

Get your financial life organized

Client One (Applicant)

Client Two (Spouse)

Have clarity about your life purpose, goals and dreams

Client One (Applicant)

Client Two (Spouse)

Benefit a charitable organization or activity

Client One (Applicant)

Client Two (Spouse)

Support a common family goal through coordinated planning

Client One (Applicant)

Client Two (Spouse)

Have a plan to leave the world a better place

Client One (Applicant)

Client Two (Spouse)

Leave behind specific intellectual, spiritual, and human assets in addition to your financial assets

Client One (Applicant)

Client Two (Spouse)

For parents only: By specifying the values, insights, stories and experiences you want passed on to your children and how you want the money you leave behind used for your children

Client One (Applicant)

Client Two (Spouse)

For special needs beneficiaries only: By providing instructions, people, and assets to support your special needs beneficiaries above a poverty lifestyle

Client One (Applicant)

Client Two (Spouse)

For business owners only: By providing for the orderly continuation and transfer of family business interests rather than a distress sale

Client One (Applicant)

Client Two (Spouse)

Planning Objectives/Family Values (FAMILY VALUES)
Planning Objectives/Family Values

Cultural values such as art, music, travel.

Client One (Applicant)

Client Two (Spouse)

Economic values such as financial responsibility, frugality, savings.

Client One (Applicant)

Client Two (Spouse)

Educational values such as study, self-improvement, academic achievements, lifelong learning.

Client One (Applicant)

Client Two (Spouse)

Emotional values such as compassion, kindness, generosity.

Client One (Applicant)

Client Two (Spouse)

Ethical values such as honesty, fairness, justice.

Client One (Applicant)

Client Two (Spouse)

Material values such as possessions, social standing, rank and title.

Client One (Applicant)

Client Two (Spouse)

Personal values such as modesty, loyalty, independence.

Client One (Applicant)

Client Two (Spouse)

Philanthropic values such as volunteer work, donations (time and money).

Client One (Applicant)

Client Two (Spouse)

Physical values such as health, relaxation, exercise, appearance.

Client One (Applicant)

Client Two (Spouse)

Public values such as citizenship, community involvement, public service.

Client One (Applicant)

Client Two (Spouse)

Recreational values such as sports, leisure time, hobbies, vacations.

Client One (Applicant)

Client Two (Spouse)

Relationship values such as family, friends, colleagues.

Client One (Applicant)

Client Two (Spouse)

Spiritual values such as faith, belief in God, inner peace.

Client One (Applicant)

Client Two (Spouse)

Other Concerns (Please list below):

Asset Assessment

Determining the ownership, value and character of your assets is essential to your estate plan. The title “ownership” is important for tax and transfer matters. The “value” is needed to determine potential tax liability. The “character” is needed to assess the manner by which the asset can transfer.

General Heading (Property) add more asset

Type (Property)

Character / Ownership Status

Title / How ownership is listed

Asset Assessment (REAL PROPERTY)

Any interest in real estate including your primary residence, vacation/second homes, mineral interests, farm land, hunting leases, etc.

General Description and/or Address add more real property asset

Character / Ownership Status

Title

Market Value

Loan Balance

Total (Market Value)

Total (Loan Balance)

Asset Assessment (PERSONAL PROPERTY , AUTOMOBILES, BOATS AND RVS)

Only list major $$ personal effects (such as jewelry, collections, antiques) individually. For all other (non-business) personal property, give an estimated lump sum of fair market value for the total of your miscellaneous property; &/or any separately-valued items.

General Description and/or Address add more asset personal property

Character / Ownership Status

Title

Market Value

Total (Market Value)

AUTOMOBILES, BOATS AND RVS

For each motor vehicle, boat, RV, etc.

General Description add more asset automobiles boats

Character / Ownership Status

Title

Market Value

Loan Balance

Total (Market Value)

Total (Loan Balance)

Asset Assessment (BANK & SAVINGS ACCOUNTS , INVESTMENT ACCOUNTS, BONDS, STOCKS AND STOCK OPTIONS)

Please list Checking Account “C”, Savings Account “S”, Certificates of Deposit “CD”, Money Market “MM” (IRAs and 401(k)'s Note: If Account is in your or your spouse’s name for the benefit of a minor, also specify minor’s name. (Acct # -last 4 digits only)

Name of Financial Institution add more bank & saving account

Type

Account #

Character / Ownership Status

Title

Value

Total (Value)

INVESTMENT ACCOUNTS, BONDS, STOCKS AND STOCK OPTIONS

List any and all investment accounts, bonds, stocks and stock options you have an interest in. If including stock options, please indicate value of vested and invested options separately. If held in a brokerage account, lump them together under each account.

Name of Financial Institution add more bank & investment account

Type

Account #

Character / Ownership Status

Title

Value

Total (Value)

Asset Assessment (LIFE INSURANCE POLICES AND ANNUITIES , RETIREMENT PLANS)

Term (T); whole life (WL); split dollar, group life (L); annuity (A). ADDITIONAL INFORMATION: Insurance company, amount (death benefit), whose life is insured / who owns the policy, the current beneficiaries, who pays the premium, and who is the life insurance agent.

Policy Type add more insurance

List insurance company name & describe policy

Owner

Value

Total (Value)

RETIREMENT PLANS

Pension (P), Profit Sharing (PS), H.R. 10, IRA, SEP, 401(K).

Plan Name add more life retirement plans

Type

Current Value

Other Pertinent Information

Total (Current Value)

Health Care Power of Attorney
Need Help?
• Health Care Power of Attorney Agent: The person authorized to make medical decisions for you if you are incapacitated or unable to communicate.
• Primary Agent: The first individual who will make health care decisions on your behalf.
• Successor Agent: An alternate who will serve if the Primary Agent cannot.
• Choosing an Agent: Select someone who understands your values, beliefs, and preferences regarding medical treatment, end-of-life care, and quality of life.
• Joint Agents: We do not recommend naming joint Health Care Agents, as disagreements may cause delays or confusion for health care providers.
• Best Practice: Naming one Primary Agent and at least one Successor Agent helps ensure continuity of care and clear decision-making.
• Assistance: If you have questions or encounter issues, contact our team at support@legalgen.com.

Health Care Power of Attorney “A Health Care Power of Attorney allows you to appoint one or more individuals to make medical decisions on your behalf if you are unable to communicate or make decisions for yourself.
You may choose to use the same agent(s) you selected for your Financial Power of Attorney, or you may name different individuals. If you are married, you may also indicate whether your spouse or life partner will have different Health Care Power of Attorney agents.
Please name a Primary Agent and at least one Successor Agent who may act if your Primary Agent is unavailable or unwilling to serve.”

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

✓

Yes

✓

No

Primary Agent : Full Legal Name: * Click "+" button to add more names

Phone Number: *

Full Address *

Would you like your Primary Healthcare Power of Attorney agents to serve jointly?

✓

Yes

✓

No

Successor Agent : * Click "+" button to add more names

Phone Number: *

Full Address *

Would you like your Successor Healthcare Power of Attorney agents to serve jointly?

✓

Yes

✓

No

When do you want your agent to be able to make health care decisions for you?

✓

Only if I am unable to make my own decisions (a doctor will determine this)

✓

Immediately (my agent can make decisions for me right away)

Asset Assessment (BUSINESS INTERESTS,MONEY OWED TO YOU)

General and Limited Partnerships, Sole Proprietorships, privately owned corporations, professional corporations, oil interests, farm and ranch interests.

Type of Interest add more business interset

How many have an Interest

Your ownership % interest

Estimated Value

Total (Estimate Value)

MONEY OWED TO YOU

Mortgages or promissory notes payable to you, or other moneys owed to you.

Name of Debtor add more Mortgages

Date of Note

Maturity Date

Owed To

Current Balance

Total (Current balance)

Asset Assessment (ANTICIPATED INHERITANCE, INTER VIVOS GIFTS, OR OUTSTANDING LAWSUIT JUDGMENT,OTHER ASSETS)

Gifts or inheritances that you expect to receive at some time in the future; or moneys that you anticipate receiving through a judgment in a lawsuit. Describe in appropriate detail.

Type of Interest add more anticipated inheritance

Who Holds The Interest

Your ownership % interest

Estimated Value

Total (Estimate Value)

OTHER ASSETS

Other property is any asset that you have that does not fit into any listed category above.

Other Assets Type add more other asset

Owner

Other Asset Name

Value

Total (Other Assets value)

Asset Assessment (SUMMARY OF VALUES)

Assets add more assets for summary of values

Amount

Client One (Applicant)

Client Two (Spouse)

Joint

Totals (Client 1 (applicant))

Totals (Client 2 (spouse))

Totals (Joint)

Total of all 3 columns

Affirmation & Signature

The undersigned understands that the Law Office of "Deborah Jean Schmidt, PLLC" will need to rely on the asset and debt information supplied by you to develop an estate plan. The undersigned also understands that inaccurate or incomplete information could negatively impact the designed estate plan. Consequently, if the Firm is retained, you will need to provide us with complete and accurate information prior to the signing of any estate planning documents.

Client 1: *

Date: *

Client 2: *

Date: *

People Who Advise You

Your various advisors play a key role in the establishment of your estate plan. For example, your financial advisor and life insurance agent may need to be contacted to confirm/ change beneficiary designations and titling of accounts.

Type of Advisor add more advisor

Advisor Name

Telephone

Potential Beneficiaries (POTENTIAL INDIVIDUAL BENEFICIARIES,POTENTIAL CHARITABLE/NON-PROFIT BENEFICIARIES)

Identify any known or potential beneficiaries of your estate. NOTE: Listing a person or particular organization in this section is not a firm indication your decision to provide for an individual or make a bequest. Rather, simply a way of identifying potential beneficiaries for discussion purposes.

Full Legal Name add more beneficiaries

DOB

Inheritance = % of your total estate

Beneficiary type

Relationship

Special Needs?

Yes No

Home Address

Phone Number

POTENTIAL CHARITABLE/NON-PROFIT BENEFICIARIES – CHURCH, COLLEGE, SOCIAL CLUB, FAVORITE PHILANTHROPY, ETC.

Name of Charity or Non-Profit Organization add more nonprofit organization

Address

Phone Number

TRUSTED PERSONS:These individuals may differ for each spouse.(Applicant Side Handle financial affairs)

FIRST, Please list the three people you trust to handle your financial affairs, in the event of your death or disability. Your spouse can be #1.

Trusted Persons #List CLIENT 1 (Applicant)

Person Name add more trusted persons

Street Address (Full Address)

Phone

Relationship

TRUSTED PERSONS:These individuals may differ for each spouse.(Spouse Side Handle financial affairs)

FIRST, Please list the three people you trust to handle your financial affairs, in the event of your death or disability. Your spouse can be #1.

Trusted Persons #List CLIENT 2 (Spouse)

Person Name add more trusted persons name

Street Address

Phone

Relationship

TRUSTED PERSONS:These individuals may differ for each spouse.(Applicant side medical decisions)

SECOND, List the three people you trust most to make your medical decisions for you in the event you are unable to do so. Again, these people do not have to be the same for both spouses; & your spouse can be #1.

Trusted Persons #List CLIENT 1 (Applicant)

Person Name add more trusted medical decision person name

Street Address (Full Address)

Phone

Relationship

TRUSTED PERSONS:These individuals may differ for each spouse.(Spouse side medical decisions)

SECOND, List the three people you trust most to make your medical decisions for you in the event you are unable to do so. Again, these people do not have to be the same for both spouses; & your spouse can be #1.

Trusted Persons #List CLIENT 2 (Spouse)

Person Name add more trusted medical decision person name

Street Address

Phone

Relationship

TRUSTED PERSONS:THIRD, KIDS' PROTECTION PLAN:

Please list the three people (or couples), by priority, that you both trust most to serve as the permanent guardian of your children in the event of the disability &/or death of both parents:

Trusted Persons #List KIDS' PROTECTION PLAN:

Person Name add more name for kids protection plan

Street Address (Full Address)

Phone

Relationship

FINALLY, who should manage your estate (possessions and wealth) in the event of your death?

Submission Screen

Please review your responses. Once you feel that your interview is complete, then click the ‘Submit’ button to submit your interview to us.
This is a huge step in getting your estate plan done. Once you click ‘Submit’, you will be directed to a webpage where you will be able to pay for your plan. Once you have paid for your plan, you will then be directed to click the button to schedule a virtual review meeting with us. Your virtual review meeting will be with one of our attorneys so that we may personally review your documents with you prior to you signing them. After your review meeting, you will receive instructions so that you can have your estate plan signed and executed.
Important: Even though you have completed this interview, your estate plan is not complete until you properly sign your documents following a virtual review meeting with one of our attorneys. Please also note that we are not engaged to help you until you have paid for your plan.

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