Blueprint Questionnaire

This questionnaire is needed by law professionals to begin the process of creating customized asset protection blueprints. Your information will be kept confidential and is protected by attorney client privilege. Your blueprint will be reviewed and completed by one of the finest asset protection attorneys in the country.

The Blueprint:

Clearly illustrates the legal entities you need to best protect your assets
Is tailored specifically to you and your Profession, Assets, Goals, and Location

Tell Us About Yourself All information is protected and kept confidential

First Name

Middle Name

Last Name

Email Address

(Please use the one you already gave us)

Alternate Email Address

Occupation

Birth Year

Prior Marriages

Are you a US Citizen?

Yes

No

Country of Citizenship

Select a Partner Type

	None
	Spouse
	Other

No Partner Selected

Your {{getPartnerSet(personalData.yourself.partner)}}

First Name

Middle Name

Last Name

Occupation

Birth Year

Email Address

Relationship to {{getPartnerSet(personalData.yourself.partner)}}

Is your {{getPartnerSet(personalData.yourself.partner)}} a US Citizen?

Yes

No

{{getPartnerSet(personalData.yourself.partner)}}'s Country of Citizenship

Your Contact Information

Add a Phone Number

Street Address

City

State

Zip Code

List of Beneficiaries (Children, Next of Kin, Friends)

Remove

First Name

Middle Name

Last Name

Age

Comments

Relationship

Other

A Few Quick Questions

Do you currently have a Revocable Living Trust?

{{personalData.has_revocable_living_trust ? personalData.has_revocable_living_trust : 'No'}}

Do you want some portion of your estate to be used for charitable purposes?

{{personalData.is_charitable_purpose ? personalData.is_charitable_purpose : 'No'}}

Are you expecting an inheritance?

{{personalData.is_expecting_inheritance ? personalData.is_expecting_inheritance : 'No'}}

Have you ever been a defendant in a lawsuit?

{{personalData.defendant_in_lawsuit ? personalData.defendant_in_lawsuit : 'No'}}

	Do you have positive passive monthly income from real estate or business investments?	{{personalData.have_passive_monthly_income ? personalData.have_passive_monthly_income : 'No'}}
	How much monthly? $

Do you receive medical insurance from an employer?

{{personalData.me_receive_medical_insurance ? personalData.me_receive_medical_insurance : 'No'}}

Does your S/O receive medical insurance from an employer?

{{personalData.so_receive_medical_insurance ? personalData.so_receive_medical_insurance : 'No'}}

Do you participate in a tax deferred Retirement Plan though an employer?

{{personalData.tax_deferred_retirement ? personalData.tax_deferred_retirement : 'No'}}

Are you considering selling your business within the next 5 years?

{{personalData.considering_selling_business ? personalData.considering_selling_business : 'No'}}

Please select the topics below in their order of importance to you.

Click on a topic below to add it.

Asset Protection from lawsuits

Estate Planning

Probate Avoidance

Business Planning

Charitable Planning

Estate Taxes

Income Taxes

Selling Your Business/Succession Planning

Income Taxes

Other

Click below to remove topic.

Click on a topic on the left to addit below.

({{(r + 1)}})

Please explain

Currently Formed Entities

What current entities are in place?

Entity Name

Entity Type (LLC's / Trust's / Corporations etc..)

% Of Ownership

Remove

List Your Assets and/or Debts

Asset/Debt Name

Asset Market Value

Debt Balance

Assign Entity Description

Remove

Net Worth: {{loanPaid() | currency}}

Total Debt: {{loanBalance() | currency}}

Tell Us About Your Insurance

Youself

Select ' Yourself '

or ' {{getPartnerSet(personalData.yourself.partner)}} '

to Add an Insurance

{{plural(newInsuranceType)}} Insurance Name

Value of Policy

{{plural(w)}} Insurance

Remove

Additional Details, Goals, and Concerns

Enter any additional comments, goals, and/or concerns

We certify that to the best of our knowledge, the forgoing is true, correct, and complete. You may rely on this information in providing advice and preparing documents for our estate and business plans. By my/our signature(s) below. I/We hereby provide Attorneys with our informed consent to share my/our information with representatives from American Society for Asset Protection, and acknowledge that I/we understand that this consent represents a waiver of any Attorney/Client privilege otherwise available. By signing below you authorize us to deal with your other advisors, and your other advisors to so deal with us.

Date:
{{todaysDate}}

Your Signature

{{plural(getPartnerSet(personalData.yourself.partner))}} Signature

Tell Us About Yourself:

Missing your First Name
Missing your Last Name
Missing your Email Address
Missing your Occupation
Missing your Birth Year
Missing your Prior Marriages Answer
Missing your US Citizenship Status
Missing {{getPartnerSet(personalData.yourself.partner)}} First Name
Missing {{getPartnerSet(personalData.yourself.partner)}} Last Name
Missing {{getPartnerSet(personalData.yourself.partner)}} Birth Year
Missing {{getPartnerSet(personalData.yourself.partner)}} Eamil Address
Missing {{getPartnerSet(personalData.yourself.partner)}} Partner Description
Missing {{getPartnerSet(personalData.yourself.partner)}} Citizenship Status

Your Contact Information:

Missing a Phone Number
Missing your Street Address
Missing your City
Missing your State
Missing your Zip/Postal Code

Signatures:

Missing {{getPartnerSet(personalData.yourself.partner)}} Signature
Missing your Signature