Warren & Migliaccio

Welcome to Warren & Migliaccio, L.L.P. Estate Planning
Please use your legal name as it appears on your license or government-issue ID

Please enter your registration details below.

First Name *

Middle Name

Last Name *

Email *

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Your Contact Details
Please submit all answers with the proper capitalization and do not abbreviate any addresses or states. Your full legal name is required for your estate planning documents. This would be the name you are referred to on your driver’s license, social security card, passport or other federal government ID. Do not forget to add your full middle name if you have one. If your driver’s license, social security card, passport, or other forms of identification do not match, use the full name indicated on your driver’s license and list the other names in the “also known as” field.

Name:

Date Of Birth *

Are you married?

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Sr

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III

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Male

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Female

Your Address

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Address Line 2

City *

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County *

Zip Code *

Your Spouse Information
Please use your legal name as it appears on your license or government-issue ID

Your spouse's Details

First Name: *

Middle Name *

Last Name: *

Email *

Date Of Birth *

Cell *

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Jr

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Sr

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III

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Other

Gender

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Male

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Female

State: *

Financial Power of Attorney
The Financial Power of attorney allows the person you name as your agent to make financial and property related decisions for you while you are alive. The power can become effective at the time you sign the document or later only in the event of your incapacity. This choice will be made at the time you sign the document with your attorney. It is recommended that you name one primary (typically spouse/partner if married) and at least one successor.

Please name who you would like to serve as your Financial Power of Attorney, also called Durable Power of Attorney.

Primary Agent : Full Legal Name: *

Street Address: *

City: *

State: *

Zip: *

Phone Number: *

Successor Agent : *

Street Address: *

City: *

State: *

Zip: *

Phone Number: *

Financial Power of Attorney - Spouse/Partner
The Financial Power of attorney allows the person you name as your agent to make financial and property related decisions for you while you are alive. The power can become effective at the time you sign the document or later only in the event of your incapacity. This choice will be made at the time you sign the document with your attorney. It is recommended that you name one primary (typically spouse/partner if married) and at least one successor.

Primary Agent : Full Legal Name: *

Street Address: *

City: *

State: *

Zip: *

Phone Number: *

Successor Agent : *

Street Address: *

City: *

State: *

Zip: *

Phone Number: *

Medical Power of Attorney
The Medical Power of attorney allows the person you name as your agent to make medically related decisions for you while you are alive. These powers become effective in the event of your incapacity. It is recommended that you name one primary (typically spouse/partner if married) and at least one successor.

Please name who you would like to serve as your Medical Power of Attorney.

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

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Yes

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No

Primary Agent : Full Legal Name: *

Street Address: *

City: *

State *

Zip: *

Phone Number: *

Successor Agent : *

Street Address: *

City: *

State *

Zip: *

Phone Number: *

Medical Power of Attorney-Spouse/Partner
The Medical Power of attorney allows the person you name as your agent to make medically related decisions for you while you are alive. These powers become effective in the event of your incapacity. It is recommended that you name one primary (typically spouse/partner if married) and at least one successor.

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

✓

Yes

✓

No

Primary Agent : Full Legal Name: *

Street Address: *

City: *

State: *

Zip: *

Phone Number: *

Successor Agent : *

Street Address: *

City: *

State: *

Zip: *

Phone Number: *

Submission Screen

Your summary Details

If you would like to review your responses, you can select each screen and review your answer or select the previous 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 estate planning documents you selected. Once you have paid for your documents, your information will be sent to our office and you will be contacted to schedule a time for you to review your documents with an attorney.

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