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Keith Wells
Amber Hunt
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(855) 486-3629
Intake Form BRONZE+
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PLEASE ANSWER ALL QUESTIONS - ALL INFORMATION IS STRICTLY CONFIDENTIAL
How did you hear about us?
Your Personal Information
Full Legal Name
*
Mr.
Mrs.
Miss
Ms.
Dr.
Prof.
Rev.
Prefix
First
Middle
Last
Suffix
Sex
*
Male
Female
Name used on legal documents
*
Marital Status
*
Single
Married
Separated
Divorced
Widowed
Citizen
*
US
Alien || Resident OR Nonresident
Address or PO Box
*
Street Address
City
State / Province / Region
ZIP / Postal Code
Phone
*
Email
*
Spouse/Domestic Partner Information
Full Legal Name
*
Mr.
Mrs.
Miss
Ms.
Dr.
Prof.
Rev.
Prefix
First
Middle
Last
Suffix
Sex
*
Male
Female
Name used on legal documents
*
Date of marriage
*
DD slash MM slash YYYY
Citizen
*
US
Alien || Resident OR Nonresident
THIS UNIQUE TRUST IS AN ATTORNEY-PREPARED TRUST PROVIDED TO INDIVIDUAL CLIENTS TO ASSIST IN PLANNING FOR NFA FIREARMS ONLY. THIS TRUST DESIGN INTENTIONALLY PROVIDES ONLY A LIMITED NUMBER OF CUSTOMIZATIONS TO KEEP THE COST DOWN. DISCUSS CUSTOMIZATION SERVICES OR A TRUST UPGRADE WITH ONE OF OUR ATTORNEYS, ESPECIALLY IF YOU DESIRE A JOINT TRUST WITH A SPOUSE OR DOMESTIC PARTNER.
Trust Design
Name of trust
*
Many clients add words such as Gun, Firearm(s), or Armory in the title. (This is recommended but not required.)
Date to be signes
MM slash DD slash YYYY
Leave blank if unknown
Check only one
*
Creation of New Bronze Trust
Restatement of Existing Bronze Trust; please provide a copy of the Existing Trust
Family Information
Untitled
*
I have no children.
I have children
List their names below
Attach an additional sheet if necessary.
Payment Information
What type of payment do you plan on using?
*
VISA
MasterCard
Check
(If you are attending a group event, please pay by credit card only)
Name on card
Billing Address
Street Address
City
State / Province / Region
ZIP / Postal Code
Card Number
Expiration Date
MM slash DD slash YYYY
CVV Code (3 digits on back)
YOUR CREDIT CARD WILL BE CHARGED FOR ANY POSTAGE FEES INCURRED.
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