Welcome to Powwow, LLC
This simple form provides us the information required for an elder plan engagement (administrative purposes)
Client's Full Name *
Your answer
Client's Active Power of Attorney (if applicable)
If Powwow, LLC will be primarily working with one or more people who have legal authority to act and sign on the named client's behalf please list their information below. Please be prepared to provide copy of POA for confirmation.
Your answer
Primary Email *
Your answer
Secondary Email
Your answer
Mailing Address *
Your answer
Secondary Address
Your answer
Primary Phone Number *
Your answer
Secondary Phone Number
Your answer
Client's Date of Birth *
MM
/
DD
/
YYYY
Spousal Date of Birth (if applicable)
MM
/
DD
/
YYYY
Comments
If additional family or third parties will be involved in this engagement there will be an opportunity to fill out a separate form naming them as authorized parties to receive information. Please make any other comments below:
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