Children's Legacy Plan Worksheet by HC120830173430

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									              CHILDREN’S LEGACY PLAN WORKSHEET


CLIENT ONE NAME:
CLIENT TWO NAME:
MY/YOUR MINOR CHILDREN:

Child Name:

Child Name:

Child Name:

Child Name:

Child Name:

Child Name:

Child Name:

Child Name:

Child Name:

Child Name:
A Child Information Worksheet (provided separately)
needs to be completed for each of your minor children
in order to provide First Responders/Temporary
Caretakers, Permanent Guardians and/or Health Care
Agents for them.




                                                                      Children’s
                                                                     Legacy Plan
                       Law Offices of Robert P. Bergman             Worksheet Page
               920 Saratoga Avenue, Suite 107, San Jose, CA 95129       1 of 6
                       www.lawbob.com / (408) 247-0444
           Contact Information Anybody Named as a First Responder
        (Temporary Caretaker) Permanent Guardian, and/or Health Care
                        Agent for Your Minor Children

     Full Legal Name:

     Address

     Home Phone:                                  Work Phone:

     Cell Phone:

     Relationship to Client One

     Relationship to Client Two

     Citizen of


     Full Legal Name:

     Address

     Home Phone:                                  Work Phone:

     Cell Phone:

     Relationship to Client One

     Relationship to Client Two

     Citizen of


     Full Legal Name:

     Address

     Home Phone:                                  Work Phone:

     Cell Phone:

     Relationship to Client One

     Relationship to Client Two

     Citizen of




  Children’s
 Legacy Plan                       Law Offices of Robert P. Bergman
Worksheet Page             920 Saratoga Avenue, Suite 107, San Jose, CA 95129
    2 of 6                         www.lawbob.com / (408) 247-0444
Full Legal Name:

Address

Home Phone:                                   Work Phone:

Cell Phone:

Relationship to Client One

Relationship to Client Two

Citizen of


Full Legal Name:

Address

Home Phone:                                   Work Phone:

Cell Phone:

Relationship to Client One

Relationship to Client Two

Citizen of


Full Legal Name:

Address

Home Phone:                                   Work Phone:

Cell Phone:

Relationship to Client One

Relationship to Client Two

Citizen of




                                                                              Children’s
                                                                             Legacy Plan
                               Law Offices of Robert P. Bergman             Worksheet Page
                       920 Saratoga Avenue, Suite 107, San Jose, CA 95129       3 of 6
                               www.lawbob.com / (408) 247-0444
     Full Legal Name:

     Address

     Home Phone:                                  Work Phone:

     Cell Phone:

     Relationship to Client One

     Relationship to Client Two

     Citizen of


     Full Legal Name:

     Address

     Home Phone:                                  Work Phone:

     Cell Phone:

     Relationship to Client One

     Relationship to Client Two

     Citizen of


     Full Legal Name:

     Address

     Home Phone:                                  Work Phone:

     Cell Phone:

     Relationship to Client One

     Relationship to Client Two

     Citizen of




  Children’s
 Legacy Plan                       Law Offices of Robert P. Bergman
Worksheet Page             920 Saratoga Avenue, Suite 107, San Jose, CA 95129
    4 of 6                         www.lawbob.com / (408) 247-0444
Full Legal Name:

Address

Home Phone:                                   Work Phone:

Cell Phone:

Relationship to Client One

Relationship to Client Two

Citizen of


Full Legal Name:

Address

Home Phone:                                   Work Phone:

Cell Phone:

Relationship to Client One

Relationship to Client Two

Citizen of


Full Legal Name:

Address

Home Phone:                                   Work Phone:

Cell Phone:

Relationship to Client One

Relationship to Client Two

Citizen of




                                                                              Children’s
                                                                             Legacy Plan
                               Law Offices of Robert P. Bergman             Worksheet Page
                       920 Saratoga Avenue, Suite 107, San Jose, CA 95129       5 of 6
                               www.lawbob.com / (408) 247-0444
          CONFIDENTIAL EXCLUSION FROM GUARDIANSHIP

     I wish to specifically exclude from guardianship of my
     minor children the following individuals.   Based on my
     experience, the person or persons name are not
     appropriate to serve as guardians for my minor children for
     the reasons I have indicated:




       INSTRUCTIONS TO GUARDIAN OF MINOR CHILDREN
     This Memorandum will be provided to you as a blank form in your completed
     Children's Legacy Plan. The form can be filled in by hand, or as a Word "form"
     document.
     The Memorandum provides guidance to the guardian of your minor children and your
     Trustee with respect to those decisions that you consider to be most important when
     it comes to raising your children, including decisions about finances, education,
     religion and discipline, child rearing practices, financial decisions, and your wishes
     regarding your children’s care.




  Children’s
 Legacy Plan                      Law Offices of Robert P. Bergman
Worksheet Page            920 Saratoga Avenue, Suite 107, San Jose, CA 95129
    6 of 6                        www.lawbob.com / (408) 247-0444

								
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