Intake Form

New Client Form

Step 1 of 3

ASSET INFORMATION

Owner & Balance How you own your assets is extremely important for the purposes of properly designing and implementing your estate plan. We just need an approximation of the value of the CLIENT’s interest.
SUMMARY OF ASSETS: for property owned jointly between CLIENT #1 & #2, enter 1/2 of the value in each section. If co-owned with someone OTHER THAN SPOUSE, put value of client's interest in appropriate column with an asterisk
Real Estate Client 1
Real Estate Client 2
Real Estate Total Value
Checking & Savings Accounts Client 1
Checking & Savings Accounts Client 2
Checking & Savings Accounts Total Value
Retirement Plans Client 1
Retirement Plans Client 2
Retirement Plans Total Value
Stocks and Bonds Client 1
Stocks and Bonds Client 2
Stocks and Bonds Total Value
Annuities Client 1
Annuities Client 2
Annuities Total Value
Whole Life Insurance Cash Value Client 1
Whole Life Insurance Cash Value Client 2
Whole Life Insurance Cash Value Total
Prepaid Funeral Plans and/or Plot Client 1
Prepaid Funeral Plans and/or Plot Client 2
Prepaid Funeral Plans and/or Plot Total Value
Money Owed to You Client 1
Money Owed to You Client 2
Money Owed to You Total Value
Business Interests Client 1
Business Interests Client 2
Business Interests Total Value
Anticipated Inheritance, etc. Client 1
Anticipated Inheritance, etc. Client 2
Anticipated Inheritance, etc. Total Value
Other Assets Client 1
Other Assets Client 2
Other Assets Total Value
Total of all Assets Client 1
Total of all Assets Client 2
Total of all Assets Combined
We recognize and respect the privacy expectations of our clients and the requirements of applicable federal and state privacy laws. We believe that making you aware of how we use your non-public personal information ("Personal Information"), and to whom it is disclosed, will form the basis for a relationship of trust between us and the clients that we serve. This Privacy Statement provides that explanation. We reserve the right to change this Privacy Statement from time to time consistent with applicable privacy laws. In the course of our business, we may collect Personal Information about you from the following sources: • From applications or other forms we receive from you or your authorized representative; • From your transactions with, or services being performed by, us, our affiliates, or others; From our internet web sites; • From the public records maintained by governmental entities that we either obtain directly from those entities, or from our affiliates or others; and • From consumer or other reporting agencies. 1. Our Policies Regarding the Protection of the Confidentiality and Security of Your Personal Information: We maintain physical, electronic and procedural safeguards to protect your Personal Information from unauthorized access or intrusion. We limit access to the Personal Information only to those employees who need such access in connection with providing products or services to you or for other legitimate business purposes. 2. Our Policies and Practices Regarding the Sharing ofY our Personal Information: • We may share your Personal Information with our affiliates, such as insurance companies, agents, and other real estate settlement service providers. We also may disclose your Personal Information to agents, brokers, third-party contractors, service providers or representatives to provide you with services you have requested. • In addition, we will disclose your Personal Information when you direct or give us permission, when we are required by law to do so, or when we suspect fraudulent or criminal activities. We also may disclose your Personal Information when otherwise permitted by applicable privacy laws such as, for example, when disclosure is needed to enforce our rights arising out of any agreement, transaction or relationship with you. One of our important responsibilities is to record documents in the public domain. Such documents may contain your Personal Information. 3. Right to Access Your Personal Information and Ability To Correct Errors Or Request Changes Or Deletion • You may have the right to access your Personal Information and, under certain circumstances, to find out to whom your Personal Information has been disclosed. You may also have the right to request correction, amendment or deletion of your Personal Information. All requests must be made in writing to the above address.

843.762.3554
info@lafondlaw.com

544 Savannah Highway
Charleston, SC 29407

Disclaimer: The information contained within this website does not constitute legal advice and does not establish an attorney-client relationship.
If you need legal advice, please contact an attorney directly.

Intake Form

New Client Form

Step 1 of 3

PERSONAL INFORMATION

CHILDREN AND/OR OTHER FAMILY MEMBERS

Section Break

Section Break

Section Break

Section Break

YOUR CONCERNS

Level of Concern (choose one)

ASSET INFORMATION