GET ALL SET Streamlined Estate Planning Workbook 4 of 4

GET ALL SET STREAMLINED ESTATE PLAN REQUEST

request(s) that Family and Elder Law of Mid-Michigan, P.C. prepare a GET ALL SET Streamlined Estate Plan, and state:

1. Contemporaneously with this GET ALL SET Streamlined Trust Estate Plan Request, I/we have authorized our Authorized Facilitator to submit information required to prepare a G Streamlined Trust Estate Plan.

2. I/we request that Family and Elder Law of Mid-Michigan, P.C. prepare the following GET ALL SET Streamlined Estate Plan:

3. I/we will contact Family and Elder Law of Mid-Michigan, P.C. to schedule the included 45-minute initial telephone conference with a licensed attorney to review and discuss my/our information and answer any questions that I/we might have. If at the conclusion of the telephone conference I/we decide not to have an estate plan prepared, I/we authorize Family and Elder Law of Mid-Michigan, P.C. to keep $350 of the retainer fee as its fee for the telephone conference.

4. If Family and Elder Law of Mid-Michigan, P.C. is able to provide me/us with such services, I/we agree to pay the above-indicated amount. A retainer fee calculated as follows is submitted with this Streamlined Trust Estate Plan Request, which will be applied against the fee if Family and Elder Law of Mid-Michigan, P.C. is able to provide the requested services. Otherwise, the retainer (less the charge for the initial conference if applicable) fee will be promptly refunded.

RETAINER FEE CALCULATION

5. I/we understand that a GET ALL SET Streamlined Trust Estate Plan includes Revocable Living Trust(s), Pour-Over Will(s), Appointment(s) of Funeral Representative, General Power of Attorney(s), Patient Advocate Designation(s), and Certificate(s) of Trust. The GET ALL SET Streamlined Trust Estate Plan does not include execution of the Plan documents or assistance in funding the Revocable Trust(s).

6. I/we understand that a GET ALL SET Streamlined Will Estate Plan includes Will(s), Appointment(s) of Funeral Respresentative, General Power(s) of Attorney, and Patient Advocate Designation(s). The GET ALL SET Streamlined Will Estate Plan does not include execution of Plan documents.

7. If I/we are requesting a GET ALL SET Streamlined Trust Estate Plan, I/we understand that in order to accomplish my/our goal of probate avoidance through the requested GET ALL SET Streamlined Trust Estate Plan, it is necessary to transfer ownership of my/our assets to the Revocable Living Trust(s). It might also be necessary to change beneficiary designations on life insurance policies, annuities, Individual Retirement Accounts, Pension Plans, and any other programs that have beneficiary designations. I/we understand that other than general advice that it will be necessary to transfer assets to the Revocable Trust(s) in order to accomplish probate avoidance (and Federal Estate Tax reduction where applicable), Family and Elder Law of Mid-Michigan, P.C. will not be providing us with any assistance in transferring any asset to the Revocable Trust(s) or in changing any beneficiary designations. I/we will be responsilbe for making any decisions about, or taking any action to, transfer assets to the Revocable Living Trust(s).

8. I/we acknowledge that Family and Elder Law of Mid-Michigan, P.C. has not yet provided me/us with any specific advice or recommendation that the GET ALL SET Streamlined Estate Plan that I/we have requested is appropriate for me/us or will accomplish my/our estate planning goals.

9. Above named has assisted me/us in electronically submitting information required to prepare a GET ALL SET Streamlined Trust Estate Plan. However, this individual has not provided me/us with any specific advice or recommendation that the GET ALL SET Streamlined Trust Estate Plan that I/we have requested in appropriate for me/us or will accomplish my/our estate planning goals. I/we have made an independent determination that we wish to have such GET ALL SET Streamlined Trust Estate Plan prepared. I/we further understand that such individual is not an agent or employee of Family and Elder Law of Mid-Michigan, P.C.

10. I/we understand that this GET ALL SET Streamlined Trust Estate Plan Request is not a contract or agreement with Family and Elder Law of Mid-Michigan, P.C., but is merely my/our request that estate planning legal services be provided. This Streamlined Trust Estate Plan Request shall only become a contract to provide estate planning legal services once Family and Elder Law of Mid-Michigan, P.C. has accepted it.

11. By signing below, we authorize our above named Financial Advisor to discuss my/our assets with Family and Elder Law of Mid-Michigan, P.C. as necessary to effectuate estate planning.