Warren & Migliaccio

REGISTRATION PAGE FOR YOUR YOUNG ADULT

First Name *

Last Name *

Email *

Password *

Instructions to start the Young Adult Incapacity Plan!

Here are a few tips before you begin:

1. This will be quick and easy! Your answers will be reviewed with a qualified attorney and can be changed.

2. This will take you less than 5 minutes to complete.

3. Your documents will be reviewed and then emailed to you and you can re-visit the site anytime to make changes.

4. At the end, you will be able to list any questions you have that the questionnaire didn’t address or to add any additional information you would like us to know.

NOTE: If you are completing this by phone, please turn your screen sideways.

Young Adult Info

Are you a parent filling this out for your college student? *

✓

Yes

✓

No

Please select "Are you a parent filling this out for your college student?".

Your Contact Details

Name:

Date Of Birth *

Also known as(optional)

Suffix(optional)

✓

Jr

✓

Sr

✓

II

✓

III

✓

Other

Gender

✓

Male

✓

Female

Your Address

Full Address: *

State

Financial Power of Attorney

Decide who should handle money, bills, and accounts if the person this plan is for cannot—their trusted money helper, known as the Financial Agent. Begin by naming your first choice, then list a backup, called the Successor Agent.

Primary Agent: * Click "+" to add agent

Street Address: *

City: *

State: *

Zip: *

Phone Number: *

Medical Power of Attorney

Pick who should make medical decisions if the person this plan covers is unable to do so. List your first choice, then add a backup.

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

✓

Yes

✓

No

Primary Agent: * Click "+" to add agent

Street Address: *

City: *

State: *

Zip: *

Phone Number: *

Submission Screen

You’re almost done. When you submit, our team will review your information, resolve any gaps, and prepare your documents. You’ll have a chance to ask questions and confirm details before anything is finalized.

If you would like to review your responses, you can select each screen and review your answer or select the preview button which will open a print screen page. Click the “Submit” button below to be directed to a page where you will be able to pay for your chosen plan. After payment is received, your information will be securely sent to our office for preparation of your documents.

Preview Answers

Your Progress