Basic Will Form

THE LAW OFFICES OF
ELLIS, YOUNG & TIDWELL L.L.P.

Application for Basic Will and Health Care Documents

For information and technical terms, please review legal topics or call
Sydney Young so that you understand how to fill out this form.

Either print this form on your printer and fill it in prior to your visit to our office
or
Fill in the form online and submit it via Email and we will
finish the Basic Will during your visit to our office.

Submitting this form does not create an attorney/client relationship. If you are interested
in any type of Estate Planning, including a basic will, living will (physicians directive),
or power of attorney, please make an appointment to see Sydney Young

Name:

Address:

Telephone Number:

Email Address:

Spouse:

Children’s Names:

Executor & Substitute Executor:

Guardian & Substitute:

Trustee & Substitute:

At what age of child do you want remainder of trust distributed?

Upon your death how do you want the estate divided:

Any Specific Bequests:

Power of Attorney: Name & Address for Financial

Name, Address and Phone for First Alternate for Financial:

Name, Address and Phone for Second Alternate for Financial:

If you want anyone different for Medical Power of attorney, please provide name, address, and phone, and state what order :

Do you want a Physicians’ Directive (Living Will)?
Yes No

My/our estate (including insurance) should be valued at less than $675,000.00 (single) / $1,350,000.00 (married) in the year 2001
Yes No

Any other comments or pertinant information:

If there is a problem with sending the information;
Click the back button and resubmit.

ED ELLIS	«	GARY YOUNG	«	WES TIDWELL
Downtown 101 West Houston « Paris, TX 75460 Tel. (903) 785-2600 « Fax. (903) 785-9500
« SYDNEY YOUNG « Loop 286 North 2765 N.E. Loop 286 « Paris, TX 75460 Tel. (903) 785-7523 « Fax. (903) 784-7306

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