Cervantes Hodges Law Firm
333 H Street, Suite 5000
Chula Vista, CA 91910
619-356-0777
Please complete this intake form before your consultation. The information you provide is confidential and protected by the Attorney-Client privilege. Upon submission, a copy will be sent to the email address you provide.
Por favor llene este formulario antes de su consulta. La información que usted provea es confidencial y está protegida por el privilegio Abogado-Cliente. Al enviar el formulario, recibirá una copia en su correo electrónico.
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Marital Status [Estado Civil]
MARRIED / DOMESTIC PARTNER - CASADO(A) / PAREJA DOMÉSTICA
SINGLE - SOLTERO(A)
WIDOWED - VIUDO(A)
DIVORCED - DIVORCIADO(A)
SPOUSE/PARTNER FIRST NAME - Nombre del Cónyuge/Pareja
SPOUSE/PARTNER LAST NAME - Apellido del Cónyuge/Pareja
SPOUSE/PARTNER DATE OF BIRTH - Fecha de Nacimiento
SPOUSE/PARTNER EMAIL - Correo del Cónyuge/Pareja
SPOUSE/PARTNER PHONE - Teléfono del Cónyuge/Pareja
DO YOU HAVE CHILDREN? * ¿Tiene hijos?
Yes
CHILD'S FULL NAMES & Date of Births
Nombre Completo de Todos Sus Hijo/as y Fecha De Nacimiento
No
PRIMARY BENEFICIARIES & SHARES * Beneficiarios Principales y Porcentajes
SPECIAL DISTRIBUTION INSTRUCTIONS (OPTIONAL) - Instrucciones Especiales de Distribución (opcional)
PROPERTY ADDRESS - Dirección de la Propiedad
(HOW TITLE IS HELD) Titularidad Actual (cómo está registrada)
IS THERE A MORTGAGE OR LIEN? ¿Hay hipoteca o gravamen?
Yes
Provide all Mortgages and Liens
No
Is there more Real Estate - Hay mas Propiedades
Yes
For each Property provide HOW TITLE IS HELD - Titularidad Actual (cómo está registrada)
Please provide Mortgage/Lender for each property.
No
WHICH ASSETS DO YOU WANT INCLUDED IN THE TRUST? ¿Qué bienes desea incluir en el fideicomiso?
BANK ACCOUNTS - CUENTAS BANCARIAS
INVESTMENT / BROKERAGE - INVERSIONES
LIFE INSURANCE - SEGURO DE VIDA
BUSINESS INTEREST - INTERÉS EN NEGOCIO
PERSONAL PROPERTY - BIENES PERSONALES
DIGITAL ASSETS / CRYPTO
VEHICLES - VEHÍCULOS
Health Care & Power of Attorney - Cuidado de Salud y Poder Notarial
In addition to the Living Trust, the firm prepares supporting documents including a Durable Power of Attorney, Advance Health Care Directive, and HIPAA Authorization for each person. Please designate your agent for these documents.
Además del Fideicomiso en Vida, la firma prepara documentos de apoyo incluyendo un Poder Notarial Duradero, Directiva Anticipada de Cuidado de Salud, y Autorización HIPAA para cada persona. Por favor designe a su agente para estos documentos.
HEALTH CARE AGENT — FULL NAME * Agente de Cuidado de Salud — Nombre Completo
RELATIONSHIP - Relación con Usted
Son - Hijo
Name and DOB
Daughter - Hija
Name and DOB
Other
Name and DOB
END-OF-LIFE WISHES (OPTIONAL) - Deseos al Final de Vida (opcional)
ORGAN DONATION? ¿Donación de Órganos?
Yes
No
Undecided (no he decidido)
OTHER COMMENTS OR QUESTIONS - Otros Comentarios o Preguntas
UPLOAD DOCUMENTS (OPTIONAL) - Subir Documentos (opcional)
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I agree to receive communications by text message and email about my inquiry. You may opt out by replying STOP or contact us at (619) 356-0777. Message frequency varies. Message and data rates may apply. Acepto recibir comunicaciones por mensaje de texto y correo electrónico sobre mi consulta. Puede cancelar respondiendo STOP o contactándonos al (619) 356-0777.
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By submitting this form, I understand that no attorney-client relationship is created until a retainer agreement is signed. The information I provide is confidential and will only be used to evaluate my legal matter. Al enviar este formulario, entiendo que no se crea una relación abogado-cliente hasta que se firme un contrato de representación. La información que proveo es confidencial y solo se usará para evaluar mi asunto legal.
Acknowledged