What do some of these terms mean? Click Here for a Glossary
PERSONAL CONTACT INFORMATION
Name:	REQUIRED INFORMATION
Address:
City:
State:
Zip Code:
Phone:
Your E-Mail:	REQUIRED INFORMATION
Fax:
Cell Phone:
TRUST INFORMATION:
Name of Trust:	REQUIRED INFORMATION
Settlor
Co-Settlor
Trustee
Co-Trustee
Successor Trustee
Estimated Value of Trust Assets

SPECIFIC GIFTS FROM THE TRUST
Specific Gifts: To add gift recipients to your trust, simply provide the details in each box. You can add multiple gift recipients to your Trust.
Name of Gift Recipient 1		Name of Gift Recipient 2
Address of Gift Recipient	(Address is optional)	Address of Gift Recipient	(Address is optional)
City		City
State		State
Postal Code		Postal Code
Gift Recipient 1's Relationship to Settlor		Gift Recipient 2's Relationship to Settlor
Describe Gifts(s):		Describe Gifts(s):
Name of Gift Recipient 3		Name of Gift Recipient 4
Address of Gift Recipient	(Address is optional)	Address of Gift Recipient	(Address is optional)
City		City
State		State
Postal Code		Postal Code
Gift Recipient 3's Relationship to Settlor		Gift Recipient 4's Relationship to Settlor
Describe Gifts(s):		Describe Gifts(s):
Please include any additional details, beneficiaries and/or gift details below: Characters Left

BENEFICIARIES OF YOUR TRUST
List of Beneficiaries of Trust: To add beneficiaries, simply provide the details in each box. You can add multiple beneficiaries to your Trust.
Name of Beneficiary 1 of Trust		Name of Beneficiary 2 of Trust
Address of Beneficiary 1	(Address is optional)	Address of Beneficiary 2	(Address is optional)
City		City
State		State
Postal Code		Postal Code
Beneficiary 1's Relationship to Settlor		Beneficiary 2's Relationship to Settlor
Beneficiary 1's Percentage of Residual of Trust (after Specific Gift, if any)	%	Beneficiary 2's Percentage of Residual of Trust (after Specific Gift, if any)	%
Name of Beneficiary 3 of Trust		Name of Beneficiary 4 of Trust
Address of Beneficiary 3	(Address is optional)	Address of Beneficiary 4	(Address is optional)
City		City
State		State
Postal Code		Postal Code
Beneficiary 3's Relationship to Settlor		Beneficiary 4's Relationship to Settlor
Beneficiary 3's Percentage of Residual of Trust (after Specific Gift, if any)	%	Beneficiary 4's Percentage of Residual of Trust (after Specific Gift, if any)	%

INDIVIDUAL LIVING TRUST NEW JERSEY ADDITIONAL OPTIONS AND SERVICES SELECTION INSTRUCTIONS
Select the checkbox in the "ORDER NOW" column to add the service to your order or select the checkbox in the "Not Sure" column to review the item selected when we speak with you over the phone. Items selected for additional information will not be added to your total order amount. Remember at Spiegel & Utrera, P.A. we will discuss each detail of your order before any credit card charges are processed.
Not Sure?	ORDER	ADDITIONAL SERVICES
		General Counsel Club Imagine having an attorney's valuable legal advice just a phone call away! Many people rush into legal situation by the seat of their pants, but with our knowledge and experience, Spiegel & Utrera, P.A. can help you to prepare by avoiding legal disputes, probate and privacy pitfalls involving your Living Trust, Pour-Over Will & Testament, Living Will, or Durable Power of Attorney, as well as how to fund your Trust. Our firm has what we call the "General Counsel Club," which is a valuable bundle of services that at the time of your initial ordering, you can receive an additional One Month Bonus so that your first year of service will cover 13 months. PLUS take a $50 discount, so you pay only $89.95 for the first 13 months of service. You get unlimited telephone consultations all year long on matters relating to legal and strategic estate planning advice for your Trust, Pour-over Will & Testament, Living Will, or Durable Power of Attorney. Plus our firm will draft annual Meeting Minutes and Resolutions for the Trust; comply with all statutes and applicable laws; our firm will act as your Trust's General Counsel; and you will receive our firm's newsletter, which is published six times a year and provides valuable insight into preserving your assets from a legal point of view.
		Indemnification Agreement What happens if someone sues the Trustee in the course of his or her duties based on the parameters described in the Trust? Why would anyone want to be a Trustee if they could be sued merely by carrying out their job? As the creator of a Trust, wouldn't you want to protect the Trustee? We strongly recommend that you enter into an agreement requiring the person forming the Trust to indemnify and hold harmless the Trustees and Successor Trustees from any actions they take on behalf of the Trust. The Indemnification Agreement costs only an additional $75 when you order the Indemnification Agreement from Spiegel & Utrera, P.A. at the time of forming your Trust. A draft Indemnification Agreement will be conveyed to you for review and Spiegel & Utrera, P.A. will make reasonable changes upon timely request to be included with your finalized Trust.
		Personal Power for Trust You would want a trusted family member or friend to make Trust decisions rather than a disinterested stranger wouldn't you? The trusted friend or family member has known you for years. Is there someone whom the person forming the Trust has complete confidence that their discretion is deemed unquestionable? With a personal power, the person forming the Trust can give the last word over one or more decisions to a particular person so they have sole and uncontrolled discretion, provided the person forming the Trust clearly and unmistakably manifests his or her intention to create a personal power in a particular Trustee. Let Spiegel & Utrera, P.A. add these powerful provisions to your Trust for $75 when you order the Personal Power of Trust from Spiegel & Utrera, P.A. at the time of forming your trust.
		Incapacity and Incompetency Protection Provisions in the Trust Will your family be prepared? What happens if the creator of the Trust loses their mental capacity? The Trust may become irrevocable upon the individual creator's incapacity or incompetency, but become revocable upon the recovery of the individual creator and perhaps allow the avoidance of guardianship proceedings. Let Spiegel & Utrera, P.A. add these powerful provisions to your Trust for $75.00.
		Asset Segregation Provisions in the Trust Every family has members with their own strengths and weaknesses. Certain family members may have business acumen running the day-to-day operations of a business, while other family members need the security of receiving periodic income hassle-free. Wouldn't it make sense to protect your family members with specially designated assets? The Trust may be drafted to allow segregated assets for many purposes such as second marriages where pre-marriage assets can be held in the event of a later divorce. Let Spiegel & Utrera, P.A. add these powerful provisions to your Trust for $75 when you order Asset Segregation Provisions from Spiegel & Utrera, P.A. at the time of forming your trust.
		"HIPAA" -- Health Insurance Portability and Accountability Act Release Authority (HIPAA Consent Document) You only want a trusted person to know your healthcare situation and your sensitive healthcare records to avoid prying eyes. A HIPAA Release Authority is an authorization to ensure privacy restrictions as to who has access to your medical records. The "HIPAA" -- Health Insurance Portability and Accountability Act Release Authority (HIPAA Consent Document) costs only an additional $75 when you order your "HIPAA" -- Health Insurance Portability and Accountability Act Release Authority (HIPAA Consent Document) from Spiegel & Utrera, P.A. at the time of forming your Trust. A draft "HIPAA" -- Health Insurance Portability and Accountability Act Release Authority (HIPAA Consent Document) will be conveyed to you for your review and Spiegel & Utrera, P.A. will make reasonable changes upon timely request to be included with your finalized Trust.
		Creditor Protection in the Trust What happens if a Trust beneficiary gets sued? Do you want a creditor to get any of the beneficiary's funds? Creditor Protection prevents creditors from attaching the interest of the beneficiary in the Trust before that interest (cash or property) is actually distributed to him or her. Let Spiegel & Utrera, P.A. add these powerful provisions to your Trust to protect the Trust and the beneficiary in the event a beneficiary is sued and a judgment creditor attempts to attach or levy the beneficiary's interest in the Trust. Let Spiegel & Utrera, P.A. add these powerful provisions to your Trust for $75 at the time of forming your trust.
		Durable Power of Attorney for Healthcare-Designation of Healthcare Representative Who do you trust to make healthcare decisions? A Durable Power of Attorney for Healthcare-Designation of Healthcare Representative is your written appointment of the person, known as the Healthcare Representative, who makes health care decisions on your behalf. If you are lacking a Durable Power of Attorney for Healthcare-Designation of Healthcare Representative to provide guidance to family and health care providers as to your wishes, decisions about your health care may be made for you by others. The individual making healthcare decisions for you may or may not be aware of your wishes concerning treatment. If you have a Durable Power of Attorney for Healthcare-Designation of Healthcare Representative, it will assure that your wishes will be carried out. The Durable Power of Attorney for Healthcare-Designation of Healthcare Representative costs only an additional $79.95 each when you order your Durable Power of Attorney for Healthcare-Designation of Healthcare Representative from Spiegel & Utrera, P.A. at the time of forming your Trust. A draft Durable Power of Attorney for Healthcare-Designation of Healthcare Representative will be conveyed to you for your review and Spiegel & Utrera, P.A. will make reasonable changes upon timely request to be included with your finalized Trust.
		Living Will-Instruction Directive A Living Will-Instruction Directive is a person's written indication to the Healthcare Representative appointed in the Durable Power of Attorney for Healthcare-Designation of Healthcare Representative of whether to provide life-sustaining treatments when diagnosed with a terminal, incurable and irreversible condition, a non-terminal, incurable and irreversible condition or permanently unconscious; whether to be artificially provided fluids and nutrition; whether to receive cardiopulmonary resuscitation; whether whole brain death is the legal standard to determine if the patient is deceased; and whether the person is donating their organs, tissues and other body parts. If you are lacking a Living Will-Instruction Directive to provide guidance to family and health care providers as to your wishes, medical providers will continue to maintain you on life support and continue to render life sustaining treatment regardless of whether you are in a comatose or vegetative state and desire otherwise. If you have a Living Will-Instruction Directive your wish will be carried out. The Living Will-Instruction Directive costs only an additional $39.95 each when you order your Living Will-Instruction Directive from Spiegel & Utrera, P.A. at the time of forming your Trust. A draft Living Will-Instruction Directive will be conveyed to you for your review and Spiegel & Utrera, P.A. will make reasonable changes upon timely request to be included with your finalized Trust.
		Specific Durable Power of Attorney A Specific Durable Limited Power of Attorney allows someone to act in your stead for a specific purpose or purposes, such as to purchase a specific property, execute a certain document, or operate a particular business. Some parties may require a Specific Durable Power of Attorney because it is drawn for a specific purpose and may be considered to be a more reliable measure of the actual intent. Also, the powers granted to the person acting on your behalf will continue in effect even if you become incapacitated or lack sufficient mental competence to handle your own affairs. The Specific Durable Power of Attorney costs only an additional $267.95 when you order your Specific Durable Power of Attorney from Spiegel & Utrera, P.A. at the time of forming your Trust. A draft Specific Durable Power of Attorney will be conveyed to you for your review and Spiegel & Utrera, P.A. will make reasonable changes upon timely request to be included with your finalized Trust.
		General Durable Power of Attorney Do you need to plan ahead to protect your family? The General Power of Attorney authorizes a person to act on behalf of another person, known as the principal. It describes a broad range of activities that can be performed on behalf of the principal. The General Power of Attorney may, if desired, contain a provision authorizing performing any act the principal could normally do, including the items specifically listed. People may obtain a General Power of Attorney to prepare for a time when they may not be able to take care of things because of mental incapacity. The General Durable Power of Attorney costs only an additional $267.95 when you order at the time of forming your Trust. A draft Specific General Power of Attorney will be conveyed to you for your review and Spiegel & Utrera, P.A. will make reasonable changes upon timely request to be included with your finalized Trust.
		Pour-Over Will with Guardian Provisions Who will take care of your minor child if you are not around? Do you want a judge to make the decision for you? You may provide for a trusted friend or family member to be guardian of your minor children in your Pour-over Will & Testament so that if you or your spouse are deceased, your trusted friend or family member is nominated as guardian for your minor children. The Pour-Over Will with Guardian Provisions costs only an additional $149.95 when you order your Pour-Over Will with Guardian Provisions from Spiegel & Utrera, P.A. at the time of forming your Trust. A draft Pour-Over Will with Guardian Provisions will be conveyed to you for your review and Spiegel & Utrera, P.A. will make reasonable changes upon timely request to be included with your finalized Trust.
		Pour-Over Last Will & Testament The Pour-Over Last Will & Testament is to put any asset into your Living Trust that you neglected to put in during your life or after you become incapacitated. The Pour-Over Last Will & Testament costs only an additional $149.95 when you order your Pour-Over Last Will & Testament from Spiegel & Utrera, P.A. at the time of forming your Trust. A draft Pour-Over Last Will & Testament will be conveyed to you for your review and Spiegel & Utrera, P.A. will make reasonable changes upon timely request to be included with your finalized Trust.
		Memorandum of Trust Do you want your Trust to be a matter of public record? You may need evidence of your Trust in order to open a bank account or to transfer ownership of real estate or a vehicle to or from the Trust. The Memorandum of Trust is prepared by Spiegel & Utrera, P.A. and executed by the Trustee(s). For privacy, a Memorandum of Trust avoids disclosure of the complete Trust document and maintains confidentiality of the entirety of the Trust document. This is useful for the transfer of assets to the Trust. The Memorandum of Trust costs only an additional $149.95 when you order your Memorandum of Trust from Spiegel & Utrera, P.A. at the time of forming your Trust. A draft Memorandum of Trust will be conveyed to you for your review and Spiegel & Utrera, P.A. will make reasonable changes upon timely request to be included with your finalized Trust.
		Verified Certificate of Trust Do you want a lawyer to verify as to the existence of the Trust to ensure that the Trust is valid? You may need evidence of your Trust in order to open a bank account or to transfer ownership of assets to or from the Trust. For privacy, a Verified Certificate of Trust avoids disclosure and maintains confidentiality of the entirety of the Trust. This is useful for the transfer of assets to the Trust. In addition, the Verified Certificate of Trust includes a lawyer attestation to certify the existence of the Trust, which acts like a legal opinion. The Verified Certificate of Trust costs only an additional $149.95 when you order your Verified Certificate of Trust from Spiegel & Utrera, P.A. at the time of forming your Trust. A draft Verified Certificate of Trust will be conveyed to you for your review and Spiegel & Utrera, P.A. will make reasonable changes upon timely request to be included with your finalized Trust.

SELECT SPEED OF SERVICE OPTIONS
	REGULAR PRIORITY SERVICE Your order will be marked for special handling, a member of the Spiegel & Utrera, P.A. staff will be assigned to actively monitor the status of your Trust and other ancillary documents. Your Trust and ancillary documents will be hand-delivered to you (if requested by you, your signature will be required upon receipt) to insure confidentiality via Federal Express, U.P.S. or other delivery service or electronic mail. The preparation and processing time for your Trust and ancillary documents is approximately two weeks after receipt of payment.
	3 BUSINESS DAY PRIORITY SERVICE Your order will be marked for special handling, a member of the Spiegel & Utrera, P.A. staff will be assigned to actively monitor the status of your Trust and other ancillary documents. Your documents will be hand-delivered to you (if requested by you, your signature will be required upon receipt) to insure confidentiality via Federal Express, U.P.S. or other delivery service or electronic mail. The preparation and processing time for your Trust and ancillary documents is 3 business days after receipt of payment of an additional $75.
	NEXT BUSINESS DAY PRIORITY SERVICE Your order will be marked for special handling, a member of the Spiegel & Utrera, P.A. staff will be assigned to actively monitor the status of your Trust and other ancillary documents. Your documents will be hand-delivered to you (if requested by you, your signature will be required upon receipt) to insure confidentiality via Federal Express, U.P.S. or other delivery service or electronic mail. The preparation and processing time for your Trust and ancillary documents is next business day after receipt of payment of an additional $150.

SELECT SHIPPING INFORMATION AND OPTIONS
Trust Packages are available for pick up at any of our office or may be shipped to you via Ground (2-3 business day) Service for a charge of $17.95 or via Overnight Delivery for a charge of $30.95 within the U.S.A. Please select the appropriate shipping options available for your area:
Select here for shipping inside the United States
	Regular Service - $17.95
	Next Day Service - $30.95
	Office Pick-up - (no charge)
Select here for shipping to Canada
	Regular Service to Canada (approximately 6 - 8 business days service) - $69.95
	International Economy to Canada (approximately 5 - 6 business days service) - $74.95
	International Priority to Canada (approximately 2 - 4 business days service) - $99.95
Select here for shipping to Europe
	International Economy to Europe (approximately 6 - 8 business days service) - $99.95
	International Priority to Europe (approximately 2 - 4 business days service) - $124.95
	Unless I check this box, I authorize delivery to my shipping address without a recipient's signature or if I check this box I understand that my order will be shipped to me signature required upon receipt. There is a $3 charge for this service.

We apologize for any inconvenience but we do not ship to P.O. Box addresses. If you selected our Office Pickup option above, skip this section and click continue to proceed with your order.
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	Please be aware that your Trust package weighs approximately 2 pounds.
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Managing Attorney

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Managing Attorney

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Dover, DE 19901
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