Appendix A: Sample Data-Gathering Form
Personal Information | ||
---|---|---|
Client | Spouse | |
Full Name | ||
Gender | ||
Maiden Name (if applicable) | ||
Current Marital Status | ||
Prior Marriages (if yes, date of dissolution) | ||
US Citizen (yes/no) | ||
Current Address | ||
Phone Number | ||
Cell Phone Number | ||
Prior State of Residence | ||
Birthdate | ||
Age | ||
Birthplace | ||
Scer | ||
Occupation | ||
Employer | ||
Length of Current Employment (years) | ||
Business Phone Number | ||
Family Members Who Depend on Your Support |
Family Advisors and Representatives | ||
---|---|---|
Name | Phone Number | |
Attorney | ||
Banker | ||
Doctor | ||
Executor(s) | ||
Financial ... |
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