{"id":7,"date":"2026-06-23T17:13:52","date_gmt":"2026-06-23T17:13:52","guid":{"rendered":"https:\/\/epqreview.gbfoundation.org\/?page_id=7"},"modified":"2026-06-23T17:13:52","modified_gmt":"2026-06-23T17:13:52","slug":"estate-planning-questionnaire","status":"publish","type":"page","link":"https:\/\/epqreview.gbfoundation.org\/index.php\/estate-planning-questionnaire\/","title":{"rendered":"Estate Planning Questionnaire"},"content":{"rendered":"\n<div class=\"wp-block-group alignfull is-layout-flow wp-block-group-is-layout-flow\">\n<div class=\"wp-block-group alignfull has-global-padding is-layout-constrained wp-block-group-is-layout-constrained\" style=\"padding-top:var(--wp--preset--spacing--50);padding-bottom:var(--wp--preset--spacing--50)\"><div id=\"epq-v2-app\" class=\"epq-v2-app\" data-epq-version=\"2\">\n\t<div class=\"epq-v2-shell\">\n\t\t<div class=\"epq-v2-progress\" aria-label=\"Questionnaire progress\">\n\t\t\t<div class=\"epq-v2-progress-top\">\n\t\t\t\t<button type=\"button\" class=\"epq-v2-home\" id=\"epq-v2-home\" aria-label=\"Return to the first screen\">\u2302<\/button>\n\t\t\t\t<p class=\"epq-v2-progress-label\">Estate Planning Questionnaire<\/p>\n\t\t\t\t<p class=\"epq-v2-progress-step\" id=\"epq-v2-progress-step\" aria-live=\"polite\">Step 1 of 1<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"epq-v2-progress-bar\" aria-hidden=\"true\">\n\t\t\t\t<div class=\"epq-v2-progress-fill\" id=\"epq-v2-progress-fill\"><\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\n\t\t<form id=\"epq-v2-form\" class=\"epq-v2-form\" method=\"post\" novalidate>\n\t\t\t<p class=\"epq-honeypot-field\">\n\t\t\t\t<label for=\"epq_v2_contact_info\">Leave this field empty<\/label>\n\t\t\t\t<input type=\"text\" name=\"epq_contact_info\" id=\"epq_v2_contact_info\" tabindex=\"-1\" autocomplete=\"off\">\n\t\t\t<\/p>\n\t\t\t<div id=\"epq-v2-stage\" class=\"epq-v2-stage\"><\/div>\n\t\t\t<div id=\"epq-v2-source\" class=\"epq-v2-source\" hidden>\n\t\t\t\t<div class=\"epq-form-step\" data-step-id=\"1\">\n\t<h2>SECTION 1: Donor Contact Information<\/h2>\n\t\n\t<h3>Person 1<\/h3>\n\t<div class=\"epq-field-group epq-field-type-radio\">\n\t\t<label class=\"epq-group-label\">Title<\/label>\n\t\t<div class=\"epq-options-wrapper\">\n\t\t\t<label><input type=\"radio\" name=\"p1_title\" value=\"Mr.\"> <span>Mr.<\/span><\/label>\n\t\t\t<label><input type=\"radio\" name=\"p1_title\" value=\"Dr.\"> <span>Dr.<\/span><\/label>\n\t\t\t<label><input type=\"radio\" name=\"p1_title\" value=\"Rev.\"> <span>Rev.<\/span><\/label>\n\t\t<\/div>\n\t<\/div>\n\t<div class=\"epq-field-group\"><label for=\"p1_name\">Full Name<\/label><input type=\"text\" name=\"p1_name\" id=\"p1_name\"><\/div>\n\t<div class=\"epq-row\">\n\t\t<div class=\"epq-field-group\"><label for=\"p1_dob\">DOB<\/label><input type=\"date\" name=\"p1_dob\" id=\"p1_dob\"><\/div>\n\t\t<div class=\"epq-field-group\"><label for=\"p1_occupation\">Occupation<\/label><input type=\"text\" name=\"p1_occupation\" id=\"p1_occupation\"><\/div>\n\t<\/div>\n\t<div class=\"epq-row\">\n\t\t<div class=\"epq-field-group\"><label for=\"p1_marriages\">No. of Marriages<\/label><input type=\"number\" name=\"p1_marriages\" id=\"p1_marriages\" min=\"0\"><\/div>\n\t\t<div class=\"epq-field-group\"><label for=\"p1_ssn\">SSN<\/label><input type=\"text\" name=\"p1_ssn\" id=\"p1_ssn\" placeholder=\"(To be requested later if necessary)\"><\/div>\n\t<\/div>\n\n\t<h3>Marriage Status<\/h3>\n\t<div class=\"epq-field-group epq-field-type-radio\">\n\t\t<label class=\"epq-group-label\">Please select your current marital status:<\/label>\n\t\t<div class=\"epq-options-wrapper epq-wrap-options\">\n\t\t\t<label><input type=\"radio\" name=\"marriage_status\" value=\"Married\"> <span>Married<\/span><\/label>\n\t\t\t<label><input type=\"radio\" name=\"marriage_status\" value=\"Divorced\"> <span>Divorced<\/span><\/label>\n\t\t\t<label><input type=\"radio\" name=\"marriage_status\" value=\"Widowed\"> <span>Widowed<\/span><\/label>\n\t\t\t<label><input type=\"radio\" name=\"marriage_status\" value=\"Single\"> <span>Single<\/span><\/label>\n\t\t\t<label><input type=\"radio\" name=\"marriage_status\" value=\"Separated\"> <span>Separated<\/span><\/label>\n\t\t\t<label><input type=\"radio\" name=\"marriage_status\" value=\"Engaged\"> <span>Engaged<\/span><\/label>\n\t\t<\/div>\n\t<\/div>\n\t\n\t<div id=\"epq_person_2_container\" class=\"epq-conditional-block\">\n\t\t<h3>Spouse<\/h3>\n\t\t<div class=\"epq-field-group epq-field-type-radio\">\n\t\t\t<label class=\"epq-group-label\">Title<\/label>\n\t\t\t<div class=\"epq-options-wrapper\">\n\t\t\t\t<label><input type=\"radio\" name=\"p2_title\" value=\"Miss.\"> <span>Miss.<\/span><\/label>\n\t\t\t\t<label><input type=\"radio\" name=\"p2_title\" value=\"Ms.\"> <span>Ms.<\/span><\/label>\n\t\t\t\t<label><input type=\"radio\" name=\"p2_title\" value=\"Mrs.\"> <span>Mrs.<\/span><\/label>\n\t\t\t\t<label><input type=\"radio\" name=\"p2_title\" value=\"Dr.\"> <span>Dr.<\/span><\/label>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"epq-field-group\"><label for=\"p2_name\">Full Name<\/label><input type=\"text\" name=\"p2_name\" id=\"p2_name\"><\/div>\n\t\t<div class=\"epq-row\">\n\t\t\t<div class=\"epq-field-group\"><label for=\"p2_dob\">DOB<\/label><input type=\"date\" name=\"p2_dob\" id=\"p2_dob\"><\/div>\n\t\t\t<div class=\"epq-field-group\"><label for=\"p2_occupation\">Occupation<\/label><input type=\"text\" name=\"p2_occupation\" id=\"p2_occupation\"><\/div>\n\t\t<\/div>\n\t\t<div class=\"epq-row\">\n\t\t\t<div class=\"epq-field-group\"><label for=\"p2_marriages\">No. of Marriages<\/label><input type=\"number\" name=\"p2_marriages\" id=\"p2_marriages\" min=\"0\"><\/div>\n\t\t\t<div class=\"epq-field-group\"><label for=\"p2_ssn\">SSN<\/label><input type=\"text\" name=\"p2_ssn\" id=\"p2_ssn\" placeholder=\"(To be requested later if necessary)\"><\/div>\n\t\t<\/div>\n\t\t<div class=\"epq-row epq-v2-spouse-county-row\">\n\t\t\t<div class=\"epq-field-group\"><label for=\"p2_county\">County<\/label><input type=\"text\" name=\"p2_county\" id=\"p2_county\"><\/div>\n\t\t<\/div>\n\t<\/div>\n\n\t<h3>CONTACT DETAILS<\/h3>\n\t<div class=\"epq-field-group\"><label for=\"street\">Street<\/label><input type=\"text\" name=\"street\" id=\"street\"><\/div>\n\t<div class=\"epq-row\">\n\t\t<div class=\"epq-field-group\"><label for=\"county\">County<\/label><input type=\"text\" name=\"county\" id=\"county\"><\/div>\n\t\t<div class=\"epq-field-group\"><label for=\"city\">City<\/label><input type=\"text\" name=\"city\" id=\"city\"><\/div>\n\t<\/div>\n\t<div class=\"epq-row\">\n\t\t<div class=\"epq_nested_row_container\">\n\t\t\t<div class=\"epq-row\">\n\t\t\t\t<div class=\"epq-field-group\"><label for=\"state\">State<\/label><input type=\"text\" name=\"state\" id=\"state\"><\/div>\n\t\t\t\t<div class=\"epq-field-group\"><label for=\"zip\">Zip<\/label><input type=\"text\" name=\"zip\" id=\"zip\"><\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"epq-field-group\"><label for=\"home_phone\">Home Phone<\/label><input type=\"tel\" name=\"home_phone\" id=\"home_phone\"><\/div>\n\t<\/div>\n\t\n\t<div id=\"epq_contact_wrapper_single\" class=\"epq-conditional-block\">\n\t\t<div class=\"epq-row\">\n\t\t\t<div class=\"epq-field-group\"><label for=\"mobile_phone_single\">Mobile Phone<\/label><input type=\"tel\" name=\"mobile_phone_single\" id=\"mobile_phone_single\"><\/div>\n\t\t\t<div class=\"epq-field-group\"><label for=\"email_single\">Email<\/label><input type=\"email\" name=\"email_single\" id=\"email_single\"><\/div>\n\t\t<\/div>\n\t<\/div>\n\t<div id=\"epq_contact_wrapper_married\" class=\"epq-conditional-block\">\n\t\t<div class=\"epq-row\">\n\t\t\t<div class=\"epq-field-group\"><label for=\"his_phone\">His Phone<\/label><input type=\"tel\" name=\"his_phone\" id=\"his_phone\"><\/div>\n\t\t\t<div class=\"epq-field-group\"><label for=\"his_email\">His Email<\/label><input type=\"email\" name=\"his_email\" id=\"his_email\"><\/div>\n\t\t<\/div>\n\t\t<div class=\"epq-row epq_her_field\">\n\t\t\t<div class=\"epq-field-group\"><label for=\"her_phone\">Her Phone<\/label><input type=\"tel\" name=\"her_phone\" id=\"her_phone\"><\/div>\n\t\t\t<div class=\"epq-field-group\"><label for=\"her_email\">Her Email<\/label><input type=\"email\" name=\"her_email\" id=\"her_email\"><\/div>\n\t\t<\/div>\n\t<\/div>\n<\/div><div class=\"epq-form-step\" data-step-id=\"2\">\n\t<h2>SECTION 2: Family Details<\/h2>\n\n\t<h4>Children's Details<\/h4>\n\t<div id=\"epq_children_container\">\n\t\t\t\t<div class=\"epq-row epq-child-row\">\n\t\t\t<div class=\"epq-field-group child-name\"><input type=\"text\" name=\"child_name[0]\" placeholder=\"Child's Name\"><\/div>\n\t\t\t<div class=\"epq-field-group child-owner\">\n\t\t\t\t<div class=\"epq-options-wrapper\"><label><input type=\"radio\" name=\"child_owner[0][]\" value=\"His\"><span>His<\/span><\/label><label><input type=\"radio\" name=\"child_owner[0][]\" value=\"Hers\"><span>Hers<\/span><\/label><label><input type=\"radio\" name=\"child_owner[0][]\" value=\"Ours\"><span>Ours<\/span><\/label><\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"epq-field-group child-age\"><input type=\"number\" name=\"child_age[0]\" placeholder=\"Age\" min=\"0\"><\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"epq-row epq-child-row\">\n\t\t\t<div class=\"epq-field-group child-name\"><input type=\"text\" name=\"child_name[1]\" placeholder=\"Child's Name\"><\/div>\n\t\t\t<div class=\"epq-field-group child-owner\">\n\t\t\t\t<div class=\"epq-options-wrapper\"><label><input type=\"radio\" name=\"child_owner[1][]\" value=\"His\"><span>His<\/span><\/label><label><input type=\"radio\" name=\"child_owner[1][]\" value=\"Hers\"><span>Hers<\/span><\/label><label><input type=\"radio\" name=\"child_owner[1][]\" value=\"Ours\"><span>Ours<\/span><\/label><\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"epq-field-group child-age\"><input type=\"number\" name=\"child_age[1]\" placeholder=\"Age\" min=\"0\"><\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"epq-row epq-child-row\">\n\t\t\t<div class=\"epq-field-group child-name\"><input type=\"text\" name=\"child_name[2]\" placeholder=\"Child's Name\"><\/div>\n\t\t\t<div class=\"epq-field-group child-owner\">\n\t\t\t\t<div class=\"epq-options-wrapper\"><label><input type=\"radio\" name=\"child_owner[2][]\" value=\"His\"><span>His<\/span><\/label><label><input type=\"radio\" name=\"child_owner[2][]\" value=\"Hers\"><span>Hers<\/span><\/label><label><input type=\"radio\" name=\"child_owner[2][]\" value=\"Ours\"><span>Ours<\/span><\/label><\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"epq-field-group child-age\"><input type=\"number\" name=\"child_age[2]\" placeholder=\"Age\" min=\"0\"><\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"epq-row epq-child-row\">\n\t\t\t<div class=\"epq-field-group child-name\"><input type=\"text\" name=\"child_name[3]\" placeholder=\"Child's Name\"><\/div>\n\t\t\t<div class=\"epq-field-group child-owner\">\n\t\t\t\t<div class=\"epq-options-wrapper\"><label><input type=\"radio\" name=\"child_owner[3][]\" value=\"His\"><span>His<\/span><\/label><label><input type=\"radio\" name=\"child_owner[3][]\" value=\"Hers\"><span>Hers<\/span><\/label><label><input type=\"radio\" name=\"child_owner[3][]\" value=\"Ours\"><span>Ours<\/span><\/label><\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"epq-field-group child-age\"><input type=\"number\" name=\"child_age[3]\" placeholder=\"Age\" min=\"0\"><\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"epq-row epq-child-row\">\n\t\t\t<div class=\"epq-field-group child-name\"><input type=\"text\" name=\"child_name[4]\" placeholder=\"Child's Name\"><\/div>\n\t\t\t<div class=\"epq-field-group child-owner\">\n\t\t\t\t<div class=\"epq-options-wrapper\"><label><input type=\"radio\" name=\"child_owner[4][]\" value=\"His\"><span>His<\/span><\/label><label><input type=\"radio\" name=\"child_owner[4][]\" value=\"Hers\"><span>Hers<\/span><\/label><label><input type=\"radio\" name=\"child_owner[4][]\" value=\"Ours\"><span>Ours<\/span><\/label><\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"epq-field-group child-age\"><input type=\"number\" name=\"child_age[4]\" placeholder=\"Age\" min=\"0\"><\/div>\n\t\t<\/div>\n\t\t\t<\/div>\n\t<button type=\"button\" id=\"epq_add_child_btn\" class=\"epq-btn-add\">+ Add Additional Child<\/button>\n\n\t<div class=\"epq-spacer\" style=\"height: 1.5rem;\"><\/div>\n\n\t<div class=\"epq-field-group epq-field-type-radio\"><label class=\"epq-group-label\">Do you plan to have more children?<\/label>\n\t\t<div class=\"epq-options-wrapper\"><label><input type=\"radio\" name=\"plan_more_children\" value=\"Yes\"> <span>Yes<\/span><\/label><label><input type=\"radio\" name=\"plan_more_children\" value=\"No\"> <span>No<\/span><\/label><\/div>\n\t<\/div>\n\n\t<h4>1. After the death of both you and your spouse, who would you appoint to have physical custody and care over your minor children?<\/h4>\n\t<div class=\"epq-field-group\"><label for=\"guardian1\">Guardian 1:<\/label><input type=\"text\" name=\"guardian1\" id=\"guardian1\"><\/div>\n\t<div class=\"epq-field-group\"><label for=\"guardian2\">Guardian 2:<\/label><input type=\"text\" name=\"guardian2\" id=\"guardian2\"><\/div>\n\n\t<h4>2. Who would you appoint to manage and distribute any property received in trust for your minor children?<\/h4>\n\t<div class=\"epq-field-group\"><label for=\"trustee1\">Trustee 1:<\/label><input type=\"text\" name=\"trustee1\" id=\"trustee1\"><\/div>\n\t<div class=\"epq-field-group\"><label for=\"trustee2\">Trustee 2:<\/label><input type=\"text\" name=\"trustee2\" id=\"trustee2\"><\/div>\n\n\t<h4>3. Who will collect your assets, pay the debts and expenses of your estate, and distribute your remaining property?<\/h4>\n\t<div class=\"epq-field-group epq-field-type-radio\"><label class=\"epq-group-label\">Is your spouse your personal representative?<\/label>\n\t\t<div class=\"epq-options-wrapper\"><label><input type=\"radio\" name=\"spouse_is_pr\" value=\"Yes\"> <span>Yes<\/span><\/label><label><input type=\"radio\" name=\"spouse_is_pr\" value=\"No\"> <span>No<\/span><\/label><\/div>\n\t<\/div>\n\t\t<div class=\"epq-conditional-block\" data-condition-field=\"spouse_is_pr\" data-condition-value=\"No\">\n\t\t\t<p class=\"epq-static-text\"><em>(Please name alternates below in the event your spouse is unable to serve.)<\/em><\/p>\n\t\t\t<h5>His 1st Alternate Personal Representative<\/h5>\n\t\t\t<div class=\"epq-row\">\n\t\t\t\t<div class=\"epq-field-group\"><label for=\"his_pr_alt1\">Name<\/label><input type=\"text\" name=\"his_pr_alt1\" id=\"his_pr_alt1\"><\/div>\n\t\t\t\t<div class=\"epq-field-group\"><label for=\"his_pr_alt1_phone\">Phone<\/label><input type=\"tel\" name=\"his_pr_alt1_phone\" id=\"his_pr_alt1_phone\"><\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"epq-field-group\"><label for=\"his_pr_alt1_address\">Street Address<\/label><input type=\"text\" name=\"his_pr_alt1_address\" id=\"his_pr_alt1_address\"><\/div>\n\t\t\t<div class=\"epq-row\">\n\t\t\t\t<div class=\"epq-field-group\"><label for=\"his_pr_alt1_city\">City<\/label><input type=\"text\" name=\"his_pr_alt1_city\" id=\"his_pr_alt1_city\"><\/div>\n\t\t\t\t<div class=\"epq-field-group\"><label for=\"his_pr_alt1_state\">State<\/label><input type=\"text\" name=\"his_pr_alt1_state\" id=\"his_pr_alt1_state\"><\/div>\n\t\t\t\t<div class=\"epq-field-group\"><label for=\"his_pr_alt1_zip\">Zip<\/label><input type=\"text\" name=\"his_pr_alt1_zip\" id=\"his_pr_alt1_zip\"><\/div>\n\t\t\t<\/div>\n\t\t\t<h5>His 2nd Alternative Representative<\/h5>\n\t\t\t<div class=\"epq-row\">\n\t\t\t\t<div class=\"epq-field-group\"><label for=\"his_pr_alt2\">Name<\/label><input type=\"text\" name=\"his_pr_alt2\" id=\"his_pr_alt2\"><\/div>\n\t\t\t\t<div class=\"epq-field-group\"><label for=\"his_pr_alt2_phone\">Phone<\/label><input type=\"tel\" name=\"his_pr_alt2_phone\" id=\"his_pr_alt2_phone\"><\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"epq-field-group\"><label for=\"his_pr_alt2_address\">Street Address<\/label><input type=\"text\" name=\"his_pr_alt2_address\" id=\"his_pr_alt2_address\"><\/div>\n\t\t\t<div class=\"epq-row\">\n\t\t\t\t<div class=\"epq-field-group\"><label for=\"his_pr_alt2_city\">City<\/label><input type=\"text\" name=\"his_pr_alt2_city\" id=\"his_pr_alt2_city\"><\/div>\n\t\t\t\t<div class=\"epq-field-group\"><label for=\"his_pr_alt2_state\">State<\/label><input type=\"text\" name=\"his_pr_alt2_state\" id=\"his_pr_alt2_state\"><\/div>\n\t\t\t\t<div class=\"epq-field-group\"><label for=\"his_pr_alt2_zip\">Zip<\/label><input type=\"text\" name=\"his_pr_alt2_zip\" id=\"his_pr_alt2_zip\"><\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"epq_her_field\">\n\t\t\t\t<h5>Her 1st Alternate Personal Representative<\/h5>\n\t\t\t\t<div class=\"epq-row\">\n\t\t\t\t\t<div class=\"epq-field-group\"><label for=\"her_pr_alt1\">Name<\/label><input type=\"text\" name=\"her_pr_alt1\" id=\"her_pr_alt1\"><\/div>\n\t\t\t\t\t<div class=\"epq-field-group\"><label for=\"her_pr_alt1_phone\">Phone<\/label><input type=\"tel\" name=\"her_pr_alt1_phone\" id=\"her_pr_alt1_phone\"><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"epq-field-group\"><label for=\"her_pr_alt1_address\">Street Address<\/label><input type=\"text\" name=\"her_pr_alt1_address\" id=\"her_pr_alt1_address\"><\/div>\n\t\t\t\t<div class=\"epq-row\">\n\t\t\t\t\t<div class=\"epq-field-group\"><label for=\"her_pr_alt1_city\">City<\/label><input type=\"text\" name=\"her_pr_alt1_city\" id=\"her_pr_alt1_city\"><\/div>\n\t\t\t\t\t<div class=\"epq-field-group\"><label for=\"her_pr_alt1_state\">State<\/label><input type=\"text\" name=\"her_pr_alt1_state\" id=\"her_pr_alt1_state\"><\/div>\n\t\t\t\t\t<div class=\"epq-field-group\"><label for=\"her_pr_alt1_zip\">Zip<\/label><input type=\"text\" name=\"her_pr_alt1_zip\" id=\"her_pr_alt1_zip\"><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<h5>Her 2nd Alternative Representative<\/h5>\n\t\t\t\t<div class=\"epq-row\">\n\t\t\t\t\t<div class=\"epq-field-group\"><label for=\"her_pr_alt2\">Name<\/label><input type=\"text\" name=\"her_pr_alt2\" id=\"her_pr_alt2\"><\/div>\n\t\t\t\t\t<div class=\"epq-field-group\"><label for=\"her_pr_alt2_phone\">Phone<\/label><input type=\"tel\" name=\"her_pr_alt2_phone\" id=\"her_pr_alt2_phone\"><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"epq-field-group\"><label for=\"her_pr_alt2_address\">Street Address<\/label><input type=\"text\" name=\"her_pr_alt2_address\" id=\"her_pr_alt2_address\"><\/div>\n\t\t\t\t<div class=\"epq-row\">\n\t\t\t\t\t<div class=\"epq-field-group\"><label for=\"her_pr_alt2_city\">City<\/label><input type=\"text\" name=\"her_pr_alt2_city\" id=\"her_pr_alt2_city\"><\/div>\n\t\t\t\t\t<div class=\"epq-field-group\"><label for=\"her_pr_alt2_state\">State<\/label><input type=\"text\" name=\"her_pr_alt2_state\" id=\"her_pr_alt2_state\"><\/div>\n\t\t\t\t\t<div class=\"epq-field-group\"><label for=\"her_pr_alt2_zip\">Zip<\/label><input type=\"text\" name=\"her_pr_alt2_zip\" id=\"her_pr_alt2_zip\"><\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\n\t<h4>4. Who would make health care decisions on your behalf if you were incapacitated?<\/h4>\n\t<div class=\"epq-field-group epq-field-type-radio\"><label class=\"epq-group-label\">Is your spouse your surrogate health care representative?<\/label>\n\t\t<div class=\"epq-options-wrapper\"><label><input type=\"radio\" name=\"spouse_is_surrogate\" value=\"Yes\"> <span>Yes<\/span><\/label><label><input type=\"radio\" name=\"spouse_is_surrogate\" value=\"No\"> <span>No<\/span><\/label><\/div>\n\t<\/div>\n\t<div class=\"epq-conditional-block\" data-condition-field=\"spouse_is_surrogate\" data-condition-value=\"No\">\n\t\t<p class=\"epq-static-text\"><em>(Please name alternates below in the event your spouse is unable to serve.)<\/em><\/p>\n\t\t<h5>His 1st Alternate:<\/h5>\n\t\t<div class=\"epq-field-group\"><label for=\"his_surrogate_alt1_name\">Name:<\/label><input type=\"text\" name=\"his_surrogate_alt1_name\" id=\"his_surrogate_alt1_name\"><\/div>\n\t\t<div class=\"epq-row\">\n\t\t\t<div class=\"epq-field-group\"><label for=\"his_surrogate_alt1_phone\">Phone Number:<\/label><input type=\"tel\" name=\"his_surrogate_alt1_phone\" id=\"his_surrogate_alt1_phone\"><\/div>\n\t\t\t<div class=\"epq-field-group\"><label for=\"his_surrogate_alt1_address\">Street Address:<\/label><input type=\"text\" name=\"his_surrogate_alt1_address\" id=\"his_surrogate_alt1_address\"><\/div>\n\t\t<\/div>\n\t\t<div class=\"epq-row\">\n\t\t\t<div class=\"epq-field-group\"><label for=\"his_surrogate_alt1_city\">City:<\/label><input type=\"text\" name=\"his_surrogate_alt1_city\" id=\"his_surrogate_alt1_city\"><\/div>\n\t\t\t<div class=\"epq-field-group\"><label for=\"his_surrogate_alt1_state\">State:<\/label><input type=\"text\" name=\"his_surrogate_alt1_state\" id=\"his_surrogate_alt1_state\"><\/div>\n\t\t\t<div class=\"epq-field-group\"><label for=\"his_surrogate_alt1_zip\">Zip:<\/label><input type=\"text\" name=\"his_surrogate_alt1_zip\" id=\"his_surrogate_alt1_zip\"><\/div>\n\t\t<\/div>\n\t\t\t<div class=\"epq_her_field\">\n\t\t\t\t<h5>Her 1st Alternate:<\/h5>\n\t\t\t\t<div class=\"epq-field-group\"><label for=\"her_surrogate_alt1_name\">Name:<\/label><input type=\"text\" name=\"her_surrogate_alt1_name\" id=\"her_surrogate_alt1_name\"><\/div>\n\t\t\t<div class=\"epq-row\">\n\t\t\t\t<div class=\"epq-field-group\"><label for=\"her_surrogate_alt1_phone\">Phone Number:<\/label><input type=\"tel\" name=\"her_surrogate_alt1_phone\" id=\"her_surrogate_alt1_phone\"><\/div>\n\t\t\t\t<div class=\"epq-field-group\"><label for=\"her_surrogate_alt1_address\">Street Address:<\/label><input type=\"text\" name=\"her_surrogate_alt1_address\" id=\"her_surrogate_alt1_address\"><\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"epq-row\">\n\t\t\t\t<div class=\"epq-field-group\"><label for=\"her_surrogate_alt1_city\">City:<\/label><input type=\"text\" name=\"her_surrogate_alt1_city\" id=\"her_surrogate_alt1_city\"><\/div>\n\t\t\t\t\t<div class=\"epq-field-group\"><label for=\"her_surrogate_alt1_state\">State:<\/label><input type=\"text\" name=\"her_surrogate_alt1_state\" id=\"her_surrogate_alt1_state\"><\/div>\n\t\t\t\t\t<div class=\"epq-field-group\"><label for=\"her_surrogate_alt1_zip\">Zip:<\/label><input type=\"text\" name=\"her_surrogate_alt1_zip\" id=\"her_surrogate_alt1_zip\"><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<h5>Her 2nd Alternate:<\/h5>\n\t\t\t\t<div class=\"epq-field-group\"><label for=\"her_surrogate_alt2_name\">Name:<\/label><input type=\"text\" name=\"her_surrogate_alt2_name\" id=\"her_surrogate_alt2_name\"><\/div>\n\t\t\t\t<div class=\"epq-row\">\n\t\t\t\t\t<div class=\"epq-field-group\"><label for=\"her_surrogate_alt2_phone\">Phone Number:<\/label><input type=\"tel\" name=\"her_surrogate_alt2_phone\" id=\"her_surrogate_alt2_phone\"><\/div>\n\t\t\t\t\t<div class=\"epq-field-group\"><label for=\"her_surrogate_alt2_address\">Street Address:<\/label><input type=\"text\" name=\"her_surrogate_alt2_address\" id=\"her_surrogate_alt2_address\"><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"epq-row\">\n\t\t\t\t\t<div class=\"epq-field-group\"><label for=\"her_surrogate_alt2_city\">City:<\/label><input type=\"text\" name=\"her_surrogate_alt2_city\" id=\"her_surrogate_alt2_city\"><\/div>\n\t\t\t\t\t<div class=\"epq-field-group\"><label for=\"her_surrogate_alt2_state\">State:<\/label><input type=\"text\" name=\"her_surrogate_alt2_state\" id=\"her_surrogate_alt2_state\"><\/div>\n\t\t\t\t\t<div class=\"epq-field-group\"><label for=\"her_surrogate_alt2_zip\">Zip:<\/label><input type=\"text\" name=\"her_surrogate_alt2_zip\" id=\"her_surrogate_alt2_zip\"><\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t<h5>His 2nd Alternate:<\/h5>\n\t\t\t<div class=\"epq-field-group\"><label for=\"his_surrogate_alt2_name\">Name:<\/label><input type=\"text\" name=\"his_surrogate_alt2_name\" id=\"his_surrogate_alt2_name\"><\/div>\n\t\t\t<div class=\"epq-row\">\n\t\t\t\t<div class=\"epq-field-group\"><label for=\"his_surrogate_alt2_phone\">Phone Number:<\/label><input type=\"tel\" name=\"his_surrogate_alt2_phone\" id=\"his_surrogate_alt2_phone\"><\/div>\n\t\t\t\t<div class=\"epq-field-group\"><label for=\"his_surrogate_alt2_address\">Street Address:<\/label><input type=\"text\" name=\"his_surrogate_alt2_address\" id=\"his_surrogate_alt2_address\"><\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"epq-row\">\n\t\t\t\t<div class=\"epq-field-group\"><label for=\"his_surrogate_alt2_city\">City:<\/label><input type=\"text\" name=\"his_surrogate_alt2_city\" id=\"his_surrogate_alt2_city\"><\/div>\n\t\t\t\t<div class=\"epq-field-group\"><label for=\"his_surrogate_alt2_state\">State:<\/label><input type=\"text\" name=\"his_surrogate_alt2_state\" id=\"his_surrogate_alt2_state\"><\/div>\n\t\t\t\t<div class=\"epq-field-group\"><label for=\"his_surrogate_alt2_zip\">Zip:<\/label><input type=\"text\" name=\"his_surrogate_alt2_zip\" id=\"his_surrogate_alt2_zip\"><\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\n\t<h4>5. Who would continue your day-to-day business, pay bills, etc. if you were incapacitated?<\/h4>\n\t<div class=\"epq-field-group epq-field-type-radio\"><label class=\"epq-group-label\">Is your spouse your Power of Attorney?<\/label>\n\t\t<div class=\"epq-options-wrapper\"><label><input type=\"radio\" name=\"spouse_is_poa\" value=\"Yes\"> <span>Yes<\/span><\/label><label><input type=\"radio\" name=\"spouse_is_poa\" value=\"No\"> <span>No<\/span><\/label><\/div>\n\t<\/div>\n\t<div class=\"epq-conditional-block\" data-condition-field=\"spouse_is_poa\" data-condition-value=\"No\">\n\t\t<p class=\"epq-static-text\"><em>(Please name alternates below in the event your spouse is unable to serve.)<\/em><\/p>\n\t\t\t<h5>His 1st Alternate:<\/h5>\n\t\t\t<div class=\"epq-field-group\"><label for=\"his_poa_alt1_name\">Name:<\/label><input type=\"text\" name=\"his_poa_alt1_name\" id=\"his_poa_alt1_name\"><\/div>\n\t\t\t<div class=\"epq-row\">\n\t\t\t\t<div class=\"epq-field-group\"><label for=\"his_poa_alt1_phone\">Phone Number:<\/label><input type=\"tel\" name=\"his_poa_alt1_phone\" id=\"his_poa_alt1_phone\"><\/div>\n\t\t\t\t<div class=\"epq-field-group\"><label for=\"his_poa_alt1_address\">Street Address:<\/label><input type=\"text\" name=\"his_poa_alt1_address\" id=\"his_poa_alt1_address\"><\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"epq-row\">\n\t\t\t\t<div class=\"epq-field-group\"><label for=\"his_poa_alt1_city\">City:<\/label><input type=\"text\" name=\"his_poa_alt1_city\" id=\"his_poa_alt1_city\"><\/div>\n\t\t\t\t<div class=\"epq-field-group\"><label for=\"his_poa_alt1_state\">State:<\/label><input type=\"text\" name=\"his_poa_alt1_state\" id=\"his_poa_alt1_state\"><\/div>\n\t\t\t\t<div class=\"epq-field-group\"><label for=\"his_poa_alt1_zip\">Zip:<\/label><input type=\"text\" name=\"his_poa_alt1_zip\" id=\"his_poa_alt1_zip\"><\/div>\n\t\t\t<\/div>\n\t\t\t<h5>His 2nd Alternate:<\/h5>\n\t\t\t<div class=\"epq-field-group\"><label for=\"his_poa_alt2_name\">Name:<\/label><input type=\"text\" name=\"his_poa_alt2_name\" id=\"his_poa_alt2_name\"><\/div>\n\t\t\t<div class=\"epq-row\">\n\t\t\t\t<div class=\"epq-field-group\"><label for=\"his_poa_alt2_phone\">Phone Number:<\/label><input type=\"tel\" name=\"his_poa_alt2_phone\" id=\"his_poa_alt2_phone\"><\/div>\n\t\t\t\t<div class=\"epq-field-group\"><label for=\"his_poa_alt2_address\">Street Address:<\/label><input type=\"text\" name=\"his_poa_alt2_address\" id=\"his_poa_alt2_address\"><\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"epq-row\">\n\t\t\t\t<div class=\"epq-field-group\"><label for=\"his_poa_alt2_city\">City:<\/label><input type=\"text\" name=\"his_poa_alt2_city\" id=\"his_poa_alt2_city\"><\/div>\n\t\t\t\t<div class=\"epq-field-group\"><label for=\"his_poa_alt2_state\">State:<\/label><input type=\"text\" name=\"his_poa_alt2_state\" id=\"his_poa_alt2_state\"><\/div>\n\t\t\t\t<div class=\"epq-field-group\"><label for=\"his_poa_alt2_zip\">Zip:<\/label><input type=\"text\" name=\"his_poa_alt2_zip\" id=\"his_poa_alt2_zip\"><\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"epq_her_field\">\n\t\t\t\t<h5>Her 1st Alternate:<\/h5>\n\t\t\t\t<div class=\"epq-field-group\"><label for=\"her_poa_alt1_name\">Name:<\/label><input type=\"text\" name=\"her_poa_alt1_name\" id=\"her_poa_alt1_name\"><\/div>\n\t\t\t\t<div class=\"epq-row\">\n\t\t\t\t\t<div class=\"epq-field-group\"><label for=\"her_poa_alt1_phone\">Phone Number:<\/label><input type=\"tel\" name=\"her_poa_alt1_phone\" id=\"her_poa_alt1_phone\"><\/div>\n\t\t\t\t\t<div class=\"epq-field-group\"><label for=\"her_poa_alt1_address\">Street Address:<\/label><input type=\"text\" name=\"her_poa_alt1_address\" id=\"her_poa_alt1_address\"><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"epq-row\">\n\t\t\t\t\t<div class=\"epq-field-group\"><label for=\"her_poa_alt1_city\">City:<\/label><input type=\"text\" name=\"her_poa_alt1_city\" id=\"her_poa_alt1_city\"><\/div>\n\t\t\t\t\t<div class=\"epq-field-group\"><label for=\"her_poa_alt1_state\">State:<\/label><input type=\"text\" name=\"her_poa_alt1_state\" id=\"her_poa_alt1_state\"><\/div>\n\t\t\t\t\t<div class=\"epq-field-group\"><label for=\"her_poa_alt1_zip\">Zip:<\/label><input type=\"text\" name=\"her_poa_alt1_zip\" id=\"her_poa_alt1_zip\"><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<h5>Her 2nd Alternate:<\/h5>\n\t\t\t\t<div class=\"epq-field-group\"><label for=\"her_poa_alt2_name\">Name:<\/label><input type=\"text\" name=\"her_poa_alt2_name\" id=\"her_poa_alt2_name\"><\/div>\n\t\t\t\t<div class=\"epq-row\">\n\t\t\t\t\t<div class=\"epq-field-group\"><label for=\"her_poa_alt2_phone\">Phone Number:<\/label><input type=\"tel\" name=\"her_poa_alt2_phone\" id=\"her_poa_alt2_phone\"><\/div>\n\t\t\t\t\t<div class=\"epq-field-group\"><label for=\"her_poa_alt2_address\">Street Address:<\/label><input type=\"text\" name=\"her_poa_alt2_address\" id=\"her_poa_alt2_address\"><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"epq-row\">\n\t\t\t\t\t<div class=\"epq-field-group\"><label for=\"her_poa_alt2_city\">City:<\/label><input type=\"text\" name=\"her_poa_alt2_city\" id=\"her_poa_alt2_city\"><\/div>\n\t\t\t\t\t<div class=\"epq-field-group\"><label for=\"her_poa_alt2_state\">State:<\/label><input type=\"text\" name=\"her_poa_alt2_state\" id=\"her_poa_alt2_state\"><\/div>\n\t\t\t\t\t<div class=\"epq-field-group\"><label for=\"her_poa_alt2_zip\">Zip:<\/label><input type=\"text\" name=\"her_poa_alt2_zip\" id=\"her_poa_alt2_zip\"><\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\n\t<div class=\"epq-field-group\"><label for=\"estate_planning_concerns\">Do you have any specific estate planning concerns?<\/label><textarea name=\"estate_planning_concerns\" id=\"estate_planning_concerns\" rows=\"5\"><\/textarea><\/div>\n<\/div>\n<div class=\"epq-form-step\" data-step-id=\"3\">\n\t<h2>SECTION 3: Distribution of Your Estate<\/h2>\n\t<p>It is assumed unless you indicate otherwise that your entire estate will pass to your spouse, if surviving.<\/p>\n\t\n\t<div class=\"epq-field-group\">\n\t\t<label for=\"pass_to_spouse_or_church\">Will you be passing you entire estate to your spouse or church where you are a member or active at the time of my death?<\/label>\n\t\t<input type=\"text\" name=\"pass_to_spouse_or_church\" id=\"pass_to_spouse_or_church\">\n\t<\/div>\n\t\n\t<div class=\"epq-field-group\">\n\t\t<label for=\"distribution_after_both_passed\">Please describe below your desired distribution after both husband and wife are passed.<\/label>\n\t\t<textarea name=\"distribution_after_both_passed\" id=\"distribution_after_both_passed\" rows=\"4\"><\/textarea>\n\t<\/div>\n\n\t<h4>1. Personal effects and household furnishings to be distributed.<\/h4>\n\t<div class=\"epq-field-group epq-field-type-radio-stack\">\n\t\t<div class=\"epq-options-wrapper-stack\">\n\t\t\t<label><input type=\"radio\" name=\"personal_effects_dist\" value=\"separate_list\"> <span>by separate list attached to will\/trust<\/span><\/label>\n\t\t\t<label><input type=\"radio\" name=\"personal_effects_dist\" value=\"discretion\"> <span>at discretion of personal representative<\/span><\/label>\n\t\t\t<label><input type=\"radio\" name=\"personal_effects_dist\" value=\"children_equal\"> <span>to children in equal shares as they choose<\/span><\/label>\n\t\t\t<label><input type=\"radio\" name=\"personal_effects_dist\" value=\"as_follows\"> <span>as follows:<\/span><\/label>\n\t\t<\/div>\n\t<\/div>\n\t<div class=\"epq-field-group epq-v2-as-follows-field\">\n\t\t<textarea name=\"personal_effects_as_follows\" id=\"personal_effects_as_follows\" class=\"epq-conditional-textarea\" placeholder=\"Describe...\"><\/textarea>\n\t<\/div>\n\t\n\t<h4>2. Specific Charitable Request(s) of cash or property:<\/h4>\n\t<div class=\"epq-field-group\">\n\t\t<label for=\"charitable_requests\">Desire to leave a bequest to upon your death? (Example: 10%, a tithe of your estate, or $XXXX?)<\/label>\n\t\t<textarea name=\"charitable_requests\" id=\"charitable_requests\" rows=\"4\"><\/textarea>\n\t<\/div>\n\n\t<div class=\"epq-field-group\">\n\t\t<label>If you have chosen to make a charitable gift, do you want us to inform the charity?<\/label>\n\t\t<div class=\"epq-options-wrapper\"><label><input type=\"radio\" name=\"inform_charity\" value=\"Yes\"> <span>Yes<\/span><\/label><label><input type=\"radio\" name=\"inform_charity\" value=\"No\"> <span>No<\/span><\/label><\/div>\n\t<\/div>\n\t\n\t<h4>3. Specific Non-Charitable Bequests of cash or property:<\/h4>\n\t<div class=\"epq-field-group\">\n\t\t<label for=\"non_charitable_bequests\">(to specifically named person or persons)<\/label>\n\t\t<textarea name=\"non_charitable_bequests\" id=\"non_charitable_bequests\" rows=\"4\"><\/textarea>\n\t<\/div>\n\n\t<h4>4. The Rest and Residue of my estate:<\/h4>\n\t<div class=\"epq-rest-residue-screen\">\n\t\t<div class=\"epq-rest-row epq-rest-row-a\">\n\t\t\t<div class=\"epq-rest-letter\">A<\/div>\n\n\t\t\t<div class=\"epq-rest-card epq-rest-card-a\">\n\n\t\t\t\t<p class=\"epq-rest-line epq-rest-line-inline epq-rest-line-support\">\n\t\t\t\t\tI (we) leave\n\t\t\t\t\t<input type=\"text\" class=\"epq-rest-input epq-rest-input-inline epq-rest-input-inline-sm epq-rest-auto-grow\" data-min-ch=\"4\" name=\"rest_residue_a_support_percent\" aria-label=\"Section A support percentage\">\n\t\t\t\t\t% to my children in trust for their care support, maintenance and education.\n\t\t\t\t<\/p>\n\n\t\t\t\t<p class=\"epq-rest-line epq-rest-line-inline epq-rest-line-age\">\n\t\t\t\t\tTrust terminates when youngest reaches\n\t\t\t\t\t<span class=\"epq-rest-inline-chunk\">\n\t\t\t\t\t\t<input type=\"text\" class=\"epq-rest-input epq-rest-input-inline epq-rest-input-inline-sm epq-rest-auto-grow\" data-min-ch=\"4\" name=\"rest_residue_a_age\" aria-label=\"Section A age\">\n\t\t\t\t\t\tyears of age,\n\t\t\t\t\t<\/span>\n\t\t\t\t\tor when, in the opinion of the trustee, has completed education.\n\t\t\t\t<\/p>\n\n\t\t\t\t<p class=\"epq-rest-line epq-rest-line-label\">At termination of the trust, remaining trust property passes:<\/p>\n\n\t\t\t\t<div class=\"epq-rest-option-row epq-rest-option-row-1\">\n\t\t\t\t\t<div class=\"epq-rest-option-number\">(1)<\/div>\n\n\t\t\t\t\t<div class=\"epq-rest-option-content\">\n\t\t\t\t\t\t<div class=\"epq-rest-option-inline\">\n\t\t\t\t\t\t\t<input type=\"text\" class=\"epq-rest-input epq-rest-input-small\" name=\"rest_residue_a_option1_percent\" aria-label=\"Section A option 1 percentage\">\n\t\t\t\t\t\t\t<span>% or $<\/span>\n\t\t\t\t\t\t\t<input type=\"text\" class=\"epq-rest-input epq-rest-input-small\" name=\"rest_residue_a_option1_amount\" aria-label=\"Section A option 1 amount\">\n\t\t\t\t\t\t\t<span>to<\/span>\n\t\t\t\t\t\t\t<input type=\"text\" class=\"epq-rest-input epq-rest-input-wide\" name=\"rest_residue_a_option1_beneficiary\" aria-label=\"Section A option 1 beneficiary\">\n\t\t\t\t\t\t<\/div>\n\n\t\t\t\t\t\t<p class=\"epq-rest-caption\">and\/or other named ministries\/charities<\/p>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\n\t\t\t\t<div class=\"epq-rest-option-row epq-rest-option-row-2\">\n\t\t\t\t\t<div class=\"epq-rest-option-number\">(2)<\/div>\n\n\t\t\t\t\t<div class=\"epq-rest-option-content\">\n\t\t\t\t\t\t<p class=\"epq-rest-line epq-rest-line-inline epq-rest-line-option2\">\n\t\t\t\t\t\t\t<input type=\"text\" class=\"epq-rest-input epq-rest-input-inline epq-rest-input-inline-sm epq-rest-auto-grow\" data-min-ch=\"4\" name=\"rest_residue_a_option2_percent\" aria-label=\"Section A option 2 percentage\">\n\t\t\t\t\t\t\t% to the children in equal shares. In the event any child predeceases me or does not survive termination of the trust, their portion shall pass:\n\t\t\t\t\t\t<\/p>\n\n\t\t\t\t\t\t<p class=\"epq-rest-line epq-rest-line-inline epq-rest-line-option3\">\n\t\t\t\t\t\t\t<input type=\"text\" class=\"epq-rest-input epq-rest-input-inline epq-rest-input-inline-sm epq-rest-auto-grow\" data-min-ch=\"4\" name=\"rest_residue_a_option3_percent\" aria-label=\"Section A option 3 percentage\">\n\t\t\t\t\t\t\t% per stripes (the property will pass through the generation i.e. to your children's children) or\n\t\t\t\t\t\t<\/p>\n\n\t\t\t\t\t\t<p class=\"epq-rest-line epq-rest-line-inline epq-rest-line-option4\">\n\t\t\t\t\t\t\t<input type=\"text\" class=\"epq-rest-input epq-rest-input-inline epq-rest-input-inline-sm epq-rest-auto-grow\" data-min-ch=\"4\" name=\"rest_residue_a_option4_percent\" aria-label=\"Section A option 4 percentage\">\n\t\t\t\t\t\t\t% per capita (the property will pass only to the surviving of your children)\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\n\t\t\t<\/div>\n\t\t<\/div>\n\n\t\t<div class=\"epq-rest-row epq-rest-row-beneficiary\">\n\t\t\t<div class=\"epq-rest-letter\">B<\/div>\n\t\t\t<div class=\"epq-rest-card epq-rest-beneficiary-card\">\n\t\t\t\t<table class=\"epq-rest-beneficiary-table\" role=\"presentation\">\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<td class=\"epq-rest-beneficiary-title-cell\" colspan=\"4\">\n\t\t\t\t\t\t\t<div class=\"epq-rest-beneficiary-title\">Beneficiary<\/div>\n\t\t\t\t\t\t<\/td>\n\t\t\t\t\t<\/tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<td class=\"epq-rest-beneficiary-col epq-rest-beneficiary-col-percent\">\n\t\t\t\t\t\t\t<div class=\"epq-rest-beneficiary-percent-wrap\">\n\t\t\t\t\t\t\t\t<input type=\"text\" class=\"epq-rest-input epq-rest-input-beneficiary-percent\" name=\"rest_residue_b_percent\" aria-label=\"Section B percentage\">\n\t\t\t\t\t\t\t\t<span class=\"epq-rest-beneficiary-percent-text\">% to<\/span>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/td>\n\t\t\t\t\t\t<td class=\"epq-rest-beneficiary-col epq-rest-beneficiary-col-first\">\n\t\t\t\t\t\t\t<div class=\"epq-rest-name-field\">\n\t\t\t\t\t\t\t\t<label for=\"rest_residue_b_beneficiary_first\">First Name<\/label>\n\t\t\t\t\t\t\t\t<input type=\"text\" class=\"epq-rest-input epq-rest-input-name\" name=\"rest_residue_b_beneficiary_first\" id=\"rest_residue_b_beneficiary_first\" aria-label=\"Section B beneficiary first name\">\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/td>\n\t\t\t\t\t\t<td class=\"epq-rest-beneficiary-col epq-rest-beneficiary-col-middle\">\n\t\t\t\t\t\t\t<div class=\"epq-rest-name-field\">\n\t\t\t\t\t\t\t\t<label for=\"rest_residue_b_beneficiary_middle\">Initial<\/label>\n\t\t\t\t\t\t\t\t<input type=\"text\" class=\"epq-rest-input epq-rest-input-name\" name=\"rest_residue_b_beneficiary_middle\" id=\"rest_residue_b_beneficiary_middle\" aria-label=\"Section B beneficiary middle initial\">\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/td>\n\t\t\t\t\t\t<td class=\"epq-rest-beneficiary-col epq-rest-beneficiary-col-last\">\n\t\t\t\t\t\t\t<div class=\"epq-rest-name-field\">\n\t\t\t\t\t\t\t\t<label for=\"rest_residue_b_beneficiary_last\">Last Name<\/label>\n\t\t\t\t\t\t\t\t<input type=\"text\" class=\"epq-rest-input epq-rest-input-name\" name=\"rest_residue_b_beneficiary_last\" id=\"rest_residue_b_beneficiary_last\" aria-label=\"Section B beneficiary last name\">\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/td>\n\t\t\t\t\t<\/tr>\n\t\t\t\t<\/table>\n\t\t\t<\/div>\n\t\t<\/div>\n\n\t\t<div class=\"epq-rest-row epq-rest-row-beneficiary\">\n\t\t\t<div class=\"epq-rest-letter\">C<\/div>\n\t\t\t<div class=\"epq-rest-card epq-rest-beneficiary-card\">\n\t\t\t\t<table class=\"epq-rest-beneficiary-table\" role=\"presentation\">\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<td class=\"epq-rest-beneficiary-title-cell\" colspan=\"4\">\n\t\t\t\t\t\t\t<div class=\"epq-rest-beneficiary-title\">Beneficiary<\/div>\n\t\t\t\t\t\t<\/td>\n\t\t\t\t\t<\/tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<td class=\"epq-rest-beneficiary-col epq-rest-beneficiary-col-percent\">\n\t\t\t\t\t\t\t<div class=\"epq-rest-beneficiary-percent-wrap\">\n\t\t\t\t\t\t\t\t<input type=\"text\" class=\"epq-rest-input epq-rest-input-beneficiary-percent\" name=\"rest_residue_c_percent\" aria-label=\"Section C percentage\">\n\t\t\t\t\t\t\t\t<span class=\"epq-rest-beneficiary-percent-text\">% to<\/span>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/td>\n\t\t\t\t\t\t<td class=\"epq-rest-beneficiary-col epq-rest-beneficiary-col-first\">\n\t\t\t\t\t\t\t<div class=\"epq-rest-name-field\">\n\t\t\t\t\t\t\t\t<label for=\"rest_residue_c_beneficiary_first\">First Name<\/label>\n\t\t\t\t\t\t\t\t<input type=\"text\" class=\"epq-rest-input epq-rest-input-name\" name=\"rest_residue_c_beneficiary_first\" id=\"rest_residue_c_beneficiary_first\" aria-label=\"Section C beneficiary first name\">\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/td>\n\t\t\t\t\t\t<td class=\"epq-rest-beneficiary-col epq-rest-beneficiary-col-middle\">\n\t\t\t\t\t\t\t<div class=\"epq-rest-name-field\">\n\t\t\t\t\t\t\t\t<label for=\"rest_residue_c_beneficiary_middle\">Initial<\/label>\n\t\t\t\t\t\t\t\t<input type=\"text\" class=\"epq-rest-input epq-rest-input-name\" name=\"rest_residue_c_beneficiary_middle\" id=\"rest_residue_c_beneficiary_middle\" aria-label=\"Section C beneficiary middle initial\">\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/td>\n\t\t\t\t\t\t<td class=\"epq-rest-beneficiary-col epq-rest-beneficiary-col-last\">\n\t\t\t\t\t\t\t<div class=\"epq-rest-name-field\">\n\t\t\t\t\t\t\t\t<label for=\"rest_residue_c_beneficiary_last\">Last Name<\/label>\n\t\t\t\t\t\t\t\t<input type=\"text\" class=\"epq-rest-input epq-rest-input-name\" name=\"rest_residue_c_beneficiary_last\" id=\"rest_residue_c_beneficiary_last\" aria-label=\"Section C beneficiary last name\">\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/td>\n\t\t\t\t\t<\/tr>\n\t\t\t\t<\/table>\n\t\t\t<\/div>\n\t\t<\/div>\n\n\t\t<div class=\"epq-rest-row epq-rest-row-beneficiary\">\n\t\t\t<div class=\"epq-rest-letter\">D<\/div>\n\t\t\t<div class=\"epq-rest-card epq-rest-beneficiary-card\">\n\t\t\t\t<table class=\"epq-rest-beneficiary-table\" role=\"presentation\">\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<td class=\"epq-rest-beneficiary-title-cell\" colspan=\"4\">\n\t\t\t\t\t\t\t<div class=\"epq-rest-beneficiary-title\">Beneficiary<\/div>\n\t\t\t\t\t\t<\/td>\n\t\t\t\t\t<\/tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<td class=\"epq-rest-beneficiary-col epq-rest-beneficiary-col-percent\">\n\t\t\t\t\t\t\t<div class=\"epq-rest-beneficiary-percent-wrap\">\n\t\t\t\t\t\t\t\t<input type=\"text\" class=\"epq-rest-input epq-rest-input-beneficiary-percent\" name=\"rest_residue_d_percent\" aria-label=\"Section D percentage\">\n\t\t\t\t\t\t\t\t<span class=\"epq-rest-beneficiary-percent-text\">% to<\/span>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/td>\n\t\t\t\t\t\t<td class=\"epq-rest-beneficiary-col epq-rest-beneficiary-col-first\">\n\t\t\t\t\t\t\t<div class=\"epq-rest-name-field\">\n\t\t\t\t\t\t\t\t<label for=\"rest_residue_d_beneficiary_first\">First Name<\/label>\n\t\t\t\t\t\t\t\t<input type=\"text\" class=\"epq-rest-input epq-rest-input-name\" name=\"rest_residue_d_beneficiary_first\" id=\"rest_residue_d_beneficiary_first\" aria-label=\"Section D beneficiary first name\">\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/td>\n\t\t\t\t\t\t<td class=\"epq-rest-beneficiary-col epq-rest-beneficiary-col-middle\">\n\t\t\t\t\t\t\t<div class=\"epq-rest-name-field\">\n\t\t\t\t\t\t\t\t<label for=\"rest_residue_d_beneficiary_middle\">Initial<\/label>\n\t\t\t\t\t\t\t\t<input type=\"text\" class=\"epq-rest-input epq-rest-input-name\" name=\"rest_residue_d_beneficiary_middle\" id=\"rest_residue_d_beneficiary_middle\" aria-label=\"Section D beneficiary middle initial\">\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/td>\n\t\t\t\t\t\t<td class=\"epq-rest-beneficiary-col epq-rest-beneficiary-col-last\">\n\t\t\t\t\t\t\t<div class=\"epq-rest-name-field\">\n\t\t\t\t\t\t\t\t<label for=\"rest_residue_d_beneficiary_last\">Last Name<\/label>\n\t\t\t\t\t\t\t\t<input type=\"text\" class=\"epq-rest-input epq-rest-input-name\" name=\"rest_residue_d_beneficiary_last\" id=\"rest_residue_d_beneficiary_last\" aria-label=\"Section D beneficiary last name\">\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/td>\n\t\t\t\t\t<\/tr>\n\t\t\t\t<\/table>\n\t\t\t<\/div>\n\t\t<\/div>\n\n\t\t<div class=\"epq-rest-row epq-rest-row-beneficiary\">\n\t\t\t<div class=\"epq-rest-letter\">E<\/div>\n\t\t\t<div class=\"epq-rest-card epq-rest-beneficiary-card\">\n\t\t\t\t<table class=\"epq-rest-beneficiary-table\" role=\"presentation\">\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<td class=\"epq-rest-beneficiary-title-cell\" colspan=\"4\">\n\t\t\t\t\t\t\t<div class=\"epq-rest-beneficiary-title\">Beneficiary<\/div>\n\t\t\t\t\t\t<\/td>\n\t\t\t\t\t<\/tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<td class=\"epq-rest-beneficiary-col epq-rest-beneficiary-col-percent\">\n\t\t\t\t\t\t\t<div class=\"epq-rest-beneficiary-percent-wrap\">\n\t\t\t\t\t\t\t\t<input type=\"text\" class=\"epq-rest-input epq-rest-input-beneficiary-percent\" name=\"rest_residue_e_percent\" aria-label=\"Section E percentage\">\n\t\t\t\t\t\t\t\t<span class=\"epq-rest-beneficiary-percent-text\">% to<\/span>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/td>\n\t\t\t\t\t\t<td class=\"epq-rest-beneficiary-col epq-rest-beneficiary-col-first\">\n\t\t\t\t\t\t\t<div class=\"epq-rest-name-field\">\n\t\t\t\t\t\t\t\t<label for=\"rest_residue_e_beneficiary_first\">First Name<\/label>\n\t\t\t\t\t\t\t\t<input type=\"text\" class=\"epq-rest-input epq-rest-input-name\" name=\"rest_residue_e_beneficiary_first\" id=\"rest_residue_e_beneficiary_first\" aria-label=\"Section E beneficiary first name\">\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/td>\n\t\t\t\t\t\t<td class=\"epq-rest-beneficiary-col epq-rest-beneficiary-col-middle\">\n\t\t\t\t\t\t\t<div class=\"epq-rest-name-field\">\n\t\t\t\t\t\t\t\t<label for=\"rest_residue_e_beneficiary_middle\">Initial<\/label>\n\t\t\t\t\t\t\t\t<input type=\"text\" class=\"epq-rest-input epq-rest-input-name\" name=\"rest_residue_e_beneficiary_middle\" id=\"rest_residue_e_beneficiary_middle\" aria-label=\"Section E beneficiary middle initial\">\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/td>\n\t\t\t\t\t\t<td class=\"epq-rest-beneficiary-col epq-rest-beneficiary-col-last\">\n\t\t\t\t\t\t\t<div class=\"epq-rest-name-field\">\n\t\t\t\t\t\t\t\t<label for=\"rest_residue_e_beneficiary_last\">Last Name<\/label>\n\t\t\t\t\t\t\t\t<input type=\"text\" class=\"epq-rest-input epq-rest-input-name\" name=\"rest_residue_e_beneficiary_last\" id=\"rest_residue_e_beneficiary_last\" aria-label=\"Section E beneficiary last name\">\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/td>\n\t\t\t\t\t<\/tr>\n\t\t\t\t<\/table>\n\t\t\t<\/div>\n\t\t<\/div>\n\n\t\t<p class=\"epq-rest-note\">(Note: The percentages listed above for distribution of the rest and residue of your estate must add up to 100%! Please list additional information in the NOTES section at the bottom of page 3 or by attaching additional pages to this form.)<\/p>\n\t<\/div>\n<\/div>\n<div class=\"epq-form-step\" data-step-id=\"4\">\n\t<h2>SECTION 4: Additional Notes<\/h2>\n\t<div class=\"epq-field-group\">\n\t\t<label for=\"additional_notes\">NOTES\/ADDITIONAL INFORMATION\/QUESTIONS<\/label>\n\t\t<textarea id=\"additional_notes\" name=\"additional_notes\" rows=\"20\"><\/textarea>\n\t<\/div>\n\t<div class=\"epq-field-group\">\n\t\t<label for=\"billing_fee\">BILLING Estimated Fee: $<\/label>\n\t\t<input type=\"text\" inputmode=\"decimal\" name=\"billing_fee\" id=\"billing_fee\" placeholder=\"0.00\">\n\t<\/div>\n<\/div><div class=\"epq-form-step\" data-step-id=\"5\">\n\t<h2>SECTION 5: Asset Inventory<\/h2>\n\t<p>(This information is collected to determine if you require Federal and\/or State estate tax avoidance planning.)<\/p>\n\t\n\t<div class=\"epq-asset-inventory\">\n\t\t<div class=\"epq-asset-header\">\n\t\t\t<div class=\"item\">ITEM<\/div>\n\t\t\t<div class=\"value\">VALUE<\/div>\n\t\t\t<div class=\"debt\">DEBT<\/div>\n\t\t\t<div class=\"joint\">HIS \/ HERS \/ JOINT<\/div>\n\t\t<\/div>\n\t\t\n\t\t\t\t<div class=\"epq-asset-row\">\n\t\t\t<div class=\"item\">Primary Residence<\/div>\n\t\t\t<div class=\"value\"><input type=\"text\" inputmode=\"decimal\" name=\"asset_primary_residence_value\" placeholder=\"$\"><\/div>\n\t\t\t<div class=\"debt\"><input type=\"text\" inputmode=\"decimal\" name=\"asset_primary_residence_debt\" placeholder=\"$\"><\/div>\n\t\t\t<div class=\"joint\">\n\t\t\t\t<div class=\"epq-options-wrapper epq-v2-owner-select-enhanced\">\n\t\t\t\t\t<label><input type=\"radio\" name=\"asset_primary_residence_owner\" value=\"His\"><span>His<\/span><\/label>\n\t\t\t\t\t<label><input type=\"radio\" name=\"asset_primary_residence_owner\" value=\"Hers\"><span>Hers<\/span><\/label>\n\t\t\t\t\t<label><input type=\"radio\" name=\"asset_primary_residence_owner\" value=\"Joint\"><span>Joint<\/span><\/label>\n\t\t\t\t\t<select class=\"epq-owner-mobile-select\" aria-label=\"Ownership\">\n\t\t\t\t\t\t<option value=\"\">Select Owner<\/option>\n\t\t\t\t\t\t<option value=\"His\">His<\/option>\n\t\t\t\t\t\t<option value=\"Hers\">Hers<\/option>\n\t\t\t\t\t\t<option value=\"Joint\">Joint<\/option>\n\t\t\t\t\t<\/select>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"epq-asset-row\">\n\t\t\t<div class=\"item\">Other Real Estate<\/div>\n\t\t\t<div class=\"value\"><input type=\"text\" inputmode=\"decimal\" name=\"asset_other_real_estate_value\" placeholder=\"$\"><\/div>\n\t\t\t<div class=\"debt\"><input type=\"text\" inputmode=\"decimal\" name=\"asset_other_real_estate_debt\" placeholder=\"$\"><\/div>\n\t\t\t<div class=\"joint\">\n\t\t\t\t<div class=\"epq-options-wrapper epq-v2-owner-select-enhanced\">\n\t\t\t\t\t<label><input type=\"radio\" name=\"asset_other_real_estate_owner\" value=\"His\"><span>His<\/span><\/label>\n\t\t\t\t\t<label><input type=\"radio\" name=\"asset_other_real_estate_owner\" value=\"Hers\"><span>Hers<\/span><\/label>\n\t\t\t\t\t<label><input type=\"radio\" name=\"asset_other_real_estate_owner\" value=\"Joint\"><span>Joint<\/span><\/label>\n\t\t\t\t\t<select class=\"epq-owner-mobile-select\" aria-label=\"Ownership\">\n\t\t\t\t\t\t<option value=\"\">Select Owner<\/option>\n\t\t\t\t\t\t<option value=\"His\">His<\/option>\n\t\t\t\t\t\t<option value=\"Hers\">Hers<\/option>\n\t\t\t\t\t\t<option value=\"Joint\">Joint<\/option>\n\t\t\t\t\t<\/select>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"epq-asset-row\">\n\t\t\t<div class=\"item\">Time Share Interest<\/div>\n\t\t\t<div class=\"value\"><input type=\"text\" inputmode=\"decimal\" name=\"asset_time_share_interest_value\" placeholder=\"$\"><\/div>\n\t\t\t<div class=\"debt\"><input type=\"text\" inputmode=\"decimal\" name=\"asset_time_share_interest_debt\" placeholder=\"$\"><\/div>\n\t\t\t<div class=\"joint\">\n\t\t\t\t<div class=\"epq-options-wrapper epq-v2-owner-select-enhanced\">\n\t\t\t\t\t<label><input type=\"radio\" name=\"asset_time_share_interest_owner\" value=\"His\"><span>His<\/span><\/label>\n\t\t\t\t\t<label><input type=\"radio\" name=\"asset_time_share_interest_owner\" value=\"Hers\"><span>Hers<\/span><\/label>\n\t\t\t\t\t<label><input type=\"radio\" name=\"asset_time_share_interest_owner\" value=\"Joint\"><span>Joint<\/span><\/label>\n\t\t\t\t\t<select class=\"epq-owner-mobile-select\" aria-label=\"Ownership\">\n\t\t\t\t\t\t<option value=\"\">Select Owner<\/option>\n\t\t\t\t\t\t<option value=\"His\">His<\/option>\n\t\t\t\t\t\t<option value=\"Hers\">Hers<\/option>\n\t\t\t\t\t\t<option value=\"Joint\">Joint<\/option>\n\t\t\t\t\t<\/select>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"epq-asset-row\">\n\t\t\t<div class=\"item\">Personal Belongings<\/div>\n\t\t\t<div class=\"value\"><input type=\"text\" inputmode=\"decimal\" name=\"asset_personal_belongings_value\" placeholder=\"$\"><\/div>\n\t\t\t<div class=\"debt\"><input type=\"text\" inputmode=\"decimal\" name=\"asset_personal_belongings_debt\" placeholder=\"$\"><\/div>\n\t\t\t<div class=\"joint\">\n\t\t\t\t<div class=\"epq-options-wrapper epq-v2-owner-select-enhanced\">\n\t\t\t\t\t<label><input type=\"radio\" name=\"asset_personal_belongings_owner\" value=\"His\"><span>His<\/span><\/label>\n\t\t\t\t\t<label><input type=\"radio\" name=\"asset_personal_belongings_owner\" value=\"Hers\"><span>Hers<\/span><\/label>\n\t\t\t\t\t<label><input type=\"radio\" name=\"asset_personal_belongings_owner\" value=\"Joint\"><span>Joint<\/span><\/label>\n\t\t\t\t\t<select class=\"epq-owner-mobile-select\" aria-label=\"Ownership\">\n\t\t\t\t\t\t<option value=\"\">Select Owner<\/option>\n\t\t\t\t\t\t<option value=\"His\">His<\/option>\n\t\t\t\t\t\t<option value=\"Hers\">Hers<\/option>\n\t\t\t\t\t\t<option value=\"Joint\">Joint<\/option>\n\t\t\t\t\t<\/select>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"epq-asset-row\">\n\t\t\t<div class=\"item\">Automobiles<\/div>\n\t\t\t<div class=\"value\"><input type=\"text\" inputmode=\"decimal\" name=\"asset_automobiles_value\" placeholder=\"$\"><\/div>\n\t\t\t<div class=\"debt\"><input type=\"text\" inputmode=\"decimal\" name=\"asset_automobiles_debt\" placeholder=\"$\"><\/div>\n\t\t\t<div class=\"joint\">\n\t\t\t\t<div class=\"epq-options-wrapper epq-v2-owner-select-enhanced\">\n\t\t\t\t\t<label><input type=\"radio\" name=\"asset_automobiles_owner\" value=\"His\"><span>His<\/span><\/label>\n\t\t\t\t\t<label><input type=\"radio\" name=\"asset_automobiles_owner\" value=\"Hers\"><span>Hers<\/span><\/label>\n\t\t\t\t\t<label><input type=\"radio\" name=\"asset_automobiles_owner\" value=\"Joint\"><span>Joint<\/span><\/label>\n\t\t\t\t\t<select class=\"epq-owner-mobile-select\" aria-label=\"Ownership\">\n\t\t\t\t\t\t<option value=\"\">Select Owner<\/option>\n\t\t\t\t\t\t<option value=\"His\">His<\/option>\n\t\t\t\t\t\t<option value=\"Hers\">Hers<\/option>\n\t\t\t\t\t\t<option value=\"Joint\">Joint<\/option>\n\t\t\t\t\t<\/select>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"epq-asset-row\">\n\t\t\t<div class=\"item\">Collectibles<\/div>\n\t\t\t<div class=\"value\"><input type=\"text\" inputmode=\"decimal\" name=\"asset_collectibles_value\" placeholder=\"$\"><\/div>\n\t\t\t<div class=\"debt\"><input type=\"text\" inputmode=\"decimal\" name=\"asset_collectibles_debt\" placeholder=\"$\"><\/div>\n\t\t\t<div class=\"joint\">\n\t\t\t\t<div class=\"epq-options-wrapper epq-v2-owner-select-enhanced\">\n\t\t\t\t\t<label><input type=\"radio\" name=\"asset_collectibles_owner\" value=\"His\"><span>His<\/span><\/label>\n\t\t\t\t\t<label><input type=\"radio\" name=\"asset_collectibles_owner\" value=\"Hers\"><span>Hers<\/span><\/label>\n\t\t\t\t\t<label><input type=\"radio\" name=\"asset_collectibles_owner\" value=\"Joint\"><span>Joint<\/span><\/label>\n\t\t\t\t\t<select class=\"epq-owner-mobile-select\" aria-label=\"Ownership\">\n\t\t\t\t\t\t<option value=\"\">Select Owner<\/option>\n\t\t\t\t\t\t<option value=\"His\">His<\/option>\n\t\t\t\t\t\t<option value=\"Hers\">Hers<\/option>\n\t\t\t\t\t\t<option value=\"Joint\">Joint<\/option>\n\t\t\t\t\t<\/select>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"epq-asset-row\">\n\t\t\t<div class=\"item\">Cash & CDs<\/div>\n\t\t\t<div class=\"value\"><input type=\"text\" inputmode=\"decimal\" name=\"asset_cash_cds_value\" placeholder=\"$\"><\/div>\n\t\t\t<div class=\"debt\"><input type=\"text\" inputmode=\"decimal\" name=\"asset_cash_cds_debt\" placeholder=\"$\"><\/div>\n\t\t\t<div class=\"joint\">\n\t\t\t\t<div class=\"epq-options-wrapper epq-v2-owner-select-enhanced\">\n\t\t\t\t\t<label><input type=\"radio\" name=\"asset_cash_cds_owner\" value=\"His\"><span>His<\/span><\/label>\n\t\t\t\t\t<label><input type=\"radio\" name=\"asset_cash_cds_owner\" value=\"Hers\"><span>Hers<\/span><\/label>\n\t\t\t\t\t<label><input type=\"radio\" name=\"asset_cash_cds_owner\" value=\"Joint\"><span>Joint<\/span><\/label>\n\t\t\t\t\t<select class=\"epq-owner-mobile-select\" aria-label=\"Ownership\">\n\t\t\t\t\t\t<option value=\"\">Select Owner<\/option>\n\t\t\t\t\t\t<option value=\"His\">His<\/option>\n\t\t\t\t\t\t<option value=\"Hers\">Hers<\/option>\n\t\t\t\t\t\t<option value=\"Joint\">Joint<\/option>\n\t\t\t\t\t<\/select>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"epq-asset-row\">\n\t\t\t<div class=\"item\">Stocks & Bonds<\/div>\n\t\t\t<div class=\"value\"><input type=\"text\" inputmode=\"decimal\" name=\"asset_stocks_bonds_value\" placeholder=\"$\"><\/div>\n\t\t\t<div class=\"debt\"><input type=\"text\" inputmode=\"decimal\" name=\"asset_stocks_bonds_debt\" placeholder=\"$\"><\/div>\n\t\t\t<div class=\"joint\">\n\t\t\t\t<div class=\"epq-options-wrapper epq-v2-owner-select-enhanced\">\n\t\t\t\t\t<label><input type=\"radio\" name=\"asset_stocks_bonds_owner\" value=\"His\"><span>His<\/span><\/label>\n\t\t\t\t\t<label><input type=\"radio\" name=\"asset_stocks_bonds_owner\" value=\"Hers\"><span>Hers<\/span><\/label>\n\t\t\t\t\t<label><input type=\"radio\" name=\"asset_stocks_bonds_owner\" value=\"Joint\"><span>Joint<\/span><\/label>\n\t\t\t\t\t<select class=\"epq-owner-mobile-select\" aria-label=\"Ownership\">\n\t\t\t\t\t\t<option value=\"\">Select Owner<\/option>\n\t\t\t\t\t\t<option value=\"His\">His<\/option>\n\t\t\t\t\t\t<option value=\"Hers\">Hers<\/option>\n\t\t\t\t\t\t<option value=\"Joint\">Joint<\/option>\n\t\t\t\t\t<\/select>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"epq-asset-row\">\n\t\t\t<div class=\"item\">Business Assets<\/div>\n\t\t\t<div class=\"value\"><input type=\"text\" inputmode=\"decimal\" name=\"asset_business_assets_value\" placeholder=\"$\"><\/div>\n\t\t\t<div class=\"debt\"><input type=\"text\" inputmode=\"decimal\" name=\"asset_business_assets_debt\" placeholder=\"$\"><\/div>\n\t\t\t<div class=\"joint\">\n\t\t\t\t<div class=\"epq-options-wrapper epq-v2-owner-select-enhanced\">\n\t\t\t\t\t<label><input type=\"radio\" name=\"asset_business_assets_owner\" value=\"His\"><span>His<\/span><\/label>\n\t\t\t\t\t<label><input type=\"radio\" name=\"asset_business_assets_owner\" value=\"Hers\"><span>Hers<\/span><\/label>\n\t\t\t\t\t<label><input type=\"radio\" name=\"asset_business_assets_owner\" value=\"Joint\"><span>Joint<\/span><\/label>\n\t\t\t\t\t<select class=\"epq-owner-mobile-select\" aria-label=\"Ownership\">\n\t\t\t\t\t\t<option value=\"\">Select Owner<\/option>\n\t\t\t\t\t\t<option value=\"His\">His<\/option>\n\t\t\t\t\t\t<option value=\"Hers\">Hers<\/option>\n\t\t\t\t\t\t<option value=\"Joint\">Joint<\/option>\n\t\t\t\t\t<\/select>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"epq-asset-row\">\n\t\t\t<div class=\"item\">Life Insurance (his)<\/div>\n\t\t\t<div class=\"value\"><input type=\"text\" inputmode=\"decimal\" name=\"asset_life_insurance_his__value\" placeholder=\"$\"><\/div>\n\t\t\t<div class=\"debt\"><input type=\"text\" inputmode=\"decimal\" name=\"asset_life_insurance_his__debt\" placeholder=\"$\"><\/div>\n\t\t\t<div class=\"joint\">\n\t\t\t\t<div class=\"epq-options-wrapper epq-v2-owner-select-enhanced\">\n\t\t\t\t\t<label><input type=\"radio\" name=\"asset_life_insurance_his__owner\" value=\"His\"><span>His<\/span><\/label>\n\t\t\t\t\t<label><input type=\"radio\" name=\"asset_life_insurance_his__owner\" value=\"Hers\"><span>Hers<\/span><\/label>\n\t\t\t\t\t<label><input type=\"radio\" name=\"asset_life_insurance_his__owner\" value=\"Joint\"><span>Joint<\/span><\/label>\n\t\t\t\t\t<select class=\"epq-owner-mobile-select\" aria-label=\"Ownership\">\n\t\t\t\t\t\t<option value=\"\">Select Owner<\/option>\n\t\t\t\t\t\t<option value=\"His\">His<\/option>\n\t\t\t\t\t\t<option value=\"Hers\">Hers<\/option>\n\t\t\t\t\t\t<option value=\"Joint\">Joint<\/option>\n\t\t\t\t\t<\/select>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"epq-asset-row\">\n\t\t\t<div class=\"item\">Life Insurance (hers)<\/div>\n\t\t\t<div class=\"value\"><input type=\"text\" inputmode=\"decimal\" name=\"asset_life_insurance_hers__value\" placeholder=\"$\"><\/div>\n\t\t\t<div class=\"debt\"><input type=\"text\" inputmode=\"decimal\" name=\"asset_life_insurance_hers__debt\" placeholder=\"$\"><\/div>\n\t\t\t<div class=\"joint\">\n\t\t\t\t<div class=\"epq-options-wrapper epq-v2-owner-select-enhanced\">\n\t\t\t\t\t<label><input type=\"radio\" name=\"asset_life_insurance_hers__owner\" value=\"His\"><span>His<\/span><\/label>\n\t\t\t\t\t<label><input type=\"radio\" name=\"asset_life_insurance_hers__owner\" value=\"Hers\"><span>Hers<\/span><\/label>\n\t\t\t\t\t<label><input type=\"radio\" name=\"asset_life_insurance_hers__owner\" value=\"Joint\"><span>Joint<\/span><\/label>\n\t\t\t\t\t<select class=\"epq-owner-mobile-select\" aria-label=\"Ownership\">\n\t\t\t\t\t\t<option value=\"\">Select Owner<\/option>\n\t\t\t\t\t\t<option value=\"His\">His<\/option>\n\t\t\t\t\t\t<option value=\"Hers\">Hers<\/option>\n\t\t\t\t\t\t<option value=\"Joint\">Joint<\/option>\n\t\t\t\t\t<\/select>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"epq-asset-row\">\n\t\t\t<div class=\"item\">Pension Plan\/IRA (his)<\/div>\n\t\t\t<div class=\"value\"><input type=\"text\" inputmode=\"decimal\" name=\"asset_pension_plan_ira_his__value\" placeholder=\"$\"><\/div>\n\t\t\t<div class=\"debt\"><input type=\"text\" inputmode=\"decimal\" name=\"asset_pension_plan_ira_his__debt\" placeholder=\"$\"><\/div>\n\t\t\t<div class=\"joint\">\n\t\t\t\t<div class=\"epq-options-wrapper epq-v2-owner-select-enhanced\">\n\t\t\t\t\t<label><input type=\"radio\" name=\"asset_pension_plan_ira_his__owner\" value=\"His\"><span>His<\/span><\/label>\n\t\t\t\t\t<label><input type=\"radio\" name=\"asset_pension_plan_ira_his__owner\" value=\"Hers\"><span>Hers<\/span><\/label>\n\t\t\t\t\t<label><input type=\"radio\" name=\"asset_pension_plan_ira_his__owner\" value=\"Joint\"><span>Joint<\/span><\/label>\n\t\t\t\t\t<select class=\"epq-owner-mobile-select\" aria-label=\"Ownership\">\n\t\t\t\t\t\t<option value=\"\">Select Owner<\/option>\n\t\t\t\t\t\t<option value=\"His\">His<\/option>\n\t\t\t\t\t\t<option value=\"Hers\">Hers<\/option>\n\t\t\t\t\t\t<option value=\"Joint\">Joint<\/option>\n\t\t\t\t\t<\/select>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"epq-asset-row\">\n\t\t\t<div class=\"item\">Pension Plan\/IRA (hers)<\/div>\n\t\t\t<div class=\"value\"><input type=\"text\" inputmode=\"decimal\" name=\"asset_pension_plan_ira_hers__value\" placeholder=\"$\"><\/div>\n\t\t\t<div class=\"debt\"><input type=\"text\" inputmode=\"decimal\" name=\"asset_pension_plan_ira_hers__debt\" placeholder=\"$\"><\/div>\n\t\t\t<div class=\"joint\">\n\t\t\t\t<div class=\"epq-options-wrapper epq-v2-owner-select-enhanced\">\n\t\t\t\t\t<label><input type=\"radio\" name=\"asset_pension_plan_ira_hers__owner\" value=\"His\"><span>His<\/span><\/label>\n\t\t\t\t\t<label><input type=\"radio\" name=\"asset_pension_plan_ira_hers__owner\" value=\"Hers\"><span>Hers<\/span><\/label>\n\t\t\t\t\t<label><input type=\"radio\" name=\"asset_pension_plan_ira_hers__owner\" value=\"Joint\"><span>Joint<\/span><\/label>\n\t\t\t\t\t<select class=\"epq-owner-mobile-select\" aria-label=\"Ownership\">\n\t\t\t\t\t\t<option value=\"\">Select Owner<\/option>\n\t\t\t\t\t\t<option value=\"His\">His<\/option>\n\t\t\t\t\t\t<option value=\"Hers\">Hers<\/option>\n\t\t\t\t\t\t<option value=\"Joint\">Joint<\/option>\n\t\t\t\t\t<\/select>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"epq-asset-row\">\n\t\t\t<div class=\"item\">Personal Loans\/Receivables<\/div>\n\t\t\t<div class=\"value\"><input type=\"text\" inputmode=\"decimal\" name=\"asset_personal_loans_receivables_value\" placeholder=\"$\"><\/div>\n\t\t\t<div class=\"debt\"><input type=\"text\" inputmode=\"decimal\" name=\"asset_personal_loans_receivables_debt\" placeholder=\"$\"><\/div>\n\t\t\t<div class=\"joint\">\n\t\t\t\t<div class=\"epq-options-wrapper epq-v2-owner-select-enhanced\">\n\t\t\t\t\t<label><input type=\"radio\" name=\"asset_personal_loans_receivables_owner\" value=\"His\"><span>His<\/span><\/label>\n\t\t\t\t\t<label><input type=\"radio\" name=\"asset_personal_loans_receivables_owner\" value=\"Hers\"><span>Hers<\/span><\/label>\n\t\t\t\t\t<label><input type=\"radio\" name=\"asset_personal_loans_receivables_owner\" value=\"Joint\"><span>Joint<\/span><\/label>\n\t\t\t\t\t<select class=\"epq-owner-mobile-select\" aria-label=\"Ownership\">\n\t\t\t\t\t\t<option value=\"\">Select Owner<\/option>\n\t\t\t\t\t\t<option value=\"His\">His<\/option>\n\t\t\t\t\t\t<option value=\"Hers\">Hers<\/option>\n\t\t\t\t\t\t<option value=\"Joint\">Joint<\/option>\n\t\t\t\t\t<\/select>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"epq-asset-row\">\n\t\t\t<div class=\"item\">Other<\/div>\n\t\t\t<div class=\"value\"><input type=\"text\" inputmode=\"decimal\" name=\"asset_other_value\" placeholder=\"$\"><\/div>\n\t\t\t<div class=\"debt\"><input type=\"text\" inputmode=\"decimal\" name=\"asset_other_debt\" placeholder=\"$\"><\/div>\n\t\t\t<div class=\"joint\">\n\t\t\t\t<div class=\"epq-options-wrapper epq-v2-owner-select-enhanced\">\n\t\t\t\t\t<label><input type=\"radio\" name=\"asset_other_owner\" value=\"His\"><span>His<\/span><\/label>\n\t\t\t\t\t<label><input type=\"radio\" name=\"asset_other_owner\" value=\"Hers\"><span>Hers<\/span><\/label>\n\t\t\t\t\t<label><input type=\"radio\" name=\"asset_other_owner\" value=\"Joint\"><span>Joint<\/span><\/label>\n\t\t\t\t\t<select class=\"epq-owner-mobile-select\" aria-label=\"Ownership\">\n\t\t\t\t\t\t<option value=\"\">Select Owner<\/option>\n\t\t\t\t\t\t<option value=\"His\">His<\/option>\n\t\t\t\t\t\t<option value=\"Hers\">Hers<\/option>\n\t\t\t\t\t\t<option value=\"Joint\">Joint<\/option>\n\t\t\t\t\t<\/select>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"epq-asset-row\">\n\t\t\t<div class=\"item\">Other<\/div>\n\t\t\t<div class=\"value\"><input type=\"text\" inputmode=\"decimal\" name=\"asset_other_value\" placeholder=\"$\"><\/div>\n\t\t\t<div class=\"debt\"><input type=\"text\" inputmode=\"decimal\" name=\"asset_other_debt\" placeholder=\"$\"><\/div>\n\t\t\t<div class=\"joint\">\n\t\t\t\t<div class=\"epq-options-wrapper epq-v2-owner-select-enhanced\">\n\t\t\t\t\t<label><input type=\"radio\" name=\"asset_other_owner\" value=\"His\"><span>His<\/span><\/label>\n\t\t\t\t\t<label><input type=\"radio\" name=\"asset_other_owner\" value=\"Hers\"><span>Hers<\/span><\/label>\n\t\t\t\t\t<label><input type=\"radio\" name=\"asset_other_owner\" value=\"Joint\"><span>Joint<\/span><\/label>\n\t\t\t\t\t<select class=\"epq-owner-mobile-select\" aria-label=\"Ownership\">\n\t\t\t\t\t\t<option value=\"\">Select Owner<\/option>\n\t\t\t\t\t\t<option value=\"His\">His<\/option>\n\t\t\t\t\t\t<option value=\"Hers\">Hers<\/option>\n\t\t\t\t\t\t<option value=\"Joint\">Joint<\/option>\n\t\t\t\t\t<\/select>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"epq-asset-row\">\n\t\t\t<div class=\"item\">Other<\/div>\n\t\t\t<div class=\"value\"><input type=\"text\" inputmode=\"decimal\" name=\"asset_other_value\" placeholder=\"$\"><\/div>\n\t\t\t<div class=\"debt\"><input type=\"text\" inputmode=\"decimal\" name=\"asset_other_debt\" placeholder=\"$\"><\/div>\n\t\t\t<div class=\"joint\">\n\t\t\t\t<div class=\"epq-options-wrapper epq-v2-owner-select-enhanced\">\n\t\t\t\t\t<label><input type=\"radio\" name=\"asset_other_owner\" value=\"His\"><span>His<\/span><\/label>\n\t\t\t\t\t<label><input type=\"radio\" name=\"asset_other_owner\" value=\"Hers\"><span>Hers<\/span><\/label>\n\t\t\t\t\t<label><input type=\"radio\" name=\"asset_other_owner\" value=\"Joint\"><span>Joint<\/span><\/label>\n\t\t\t\t\t<select class=\"epq-owner-mobile-select\" aria-label=\"Ownership\">\n\t\t\t\t\t\t<option value=\"\">Select Owner<\/option>\n\t\t\t\t\t\t<option value=\"His\">His<\/option>\n\t\t\t\t\t\t<option value=\"Hers\">Hers<\/option>\n\t\t\t\t\t\t<option value=\"Joint\">Joint<\/option>\n\t\t\t\t\t<\/select>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t<\/div>\n<\/div><div class=\"epq-form-step\" data-step-id=\"6\">\n\t<h2>SECTION 6: Deeds<\/h2>\n\t<p>(Only needed for RLT preparation)<\/p>\n\n\t\t<div class=\"epq-deed-block\">\n\t\t\t\t<div class=\"epq-field-group\"><label for=\"deed_1_street\">Street Address:<\/label><input type=\"text\" name=\"deed_1_street\" id=\"deed_1_street\"><\/div>\n\t\t<div class=\"epq-row\">\n\t\t\t<div class=\"epq-field-group\"><label for=\"deed_1_county\">County:<\/label><input type=\"text\" name=\"deed_1_county\" id=\"deed_1_county\"><\/div>\n\t\t<\/div>\n\t\t<div class=\"epq-row\">\n\t\t\t<div class=\"epq-field-group\"><label for=\"deed_1_city\">City:<\/label><input type=\"text\" name=\"deed_1_city\" id=\"deed_1_city\"><\/div>\n\t\t\t<div class=\"epq-field-group\"><label for=\"deed_1_state\">State:<\/label><input type=\"text\" name=\"deed_1_state\" id=\"deed_1_state\"><\/div>\n\t\t\t<div class=\"epq-field-group\"><label for=\"deed_1_zip\">Zip:<\/label><input type=\"text\" name=\"deed_1_zip\" id=\"deed_1_zip\"><\/div>\n\t\t<\/div>\n\t\t<div class=\"epq-row\">\n\t\t\t<div class=\"epq-field-group\"><label for=\"deed_1_purchase_date\">Purchase Date:<\/label><input type=\"date\" name=\"deed_1_purchase_date\" id=\"deed_1_purchase_date\"><\/div>\n\t\t\t<div class=\"epq-field-group\"><label for=\"deed_1_mp\">M\/P:<\/label><input type=\"text\" name=\"deed_1_mp\" id=\"deed_1_mp\"><\/div>\n\t\t<\/div>\n\t\t<div class=\"epq-row\">\n\t\t\t<div class=\"epq-field-group\"><label for=\"deed_1_grantor\">Grantor:<\/label><input type=\"text\" name=\"deed_1_grantor\" id=\"deed_1_grantor\"><\/div>\n\t\t\t<div class=\"epq-field-group\"><label for=\"deed_1_book\">Deed Book:<\/label><input type=\"text\" name=\"deed_1_book\" id=\"deed_1_book\"><\/div>\n\t\t\t<div class=\"epq-field-group\"><label for=\"deed_1_page\">page:<\/label><input type=\"text\" name=\"deed_1_page\" id=\"deed_1_page\"><\/div>\n\t\t<\/div>\n\t<\/div>\n\t\t<div class=\"epq-deed-block\">\n\t\t\t\t\t<hr class=\"epq-deed-separator\">\n\t\t\t\t<div class=\"epq-field-group\"><label for=\"deed_2_street\">Street Address:<\/label><input type=\"text\" name=\"deed_2_street\" id=\"deed_2_street\"><\/div>\n\t\t<div class=\"epq-row\">\n\t\t\t<div class=\"epq-field-group\"><label for=\"deed_2_county\">County:<\/label><input type=\"text\" name=\"deed_2_county\" id=\"deed_2_county\"><\/div>\n\t\t<\/div>\n\t\t<div class=\"epq-row\">\n\t\t\t<div class=\"epq-field-group\"><label for=\"deed_2_city\">City:<\/label><input type=\"text\" name=\"deed_2_city\" id=\"deed_2_city\"><\/div>\n\t\t\t<div class=\"epq-field-group\"><label for=\"deed_2_state\">State:<\/label><input type=\"text\" name=\"deed_2_state\" id=\"deed_2_state\"><\/div>\n\t\t\t<div class=\"epq-field-group\"><label for=\"deed_2_zip\">Zip:<\/label><input type=\"text\" name=\"deed_2_zip\" id=\"deed_2_zip\"><\/div>\n\t\t<\/div>\n\t\t<div class=\"epq-row\">\n\t\t\t<div class=\"epq-field-group\"><label for=\"deed_2_purchase_date\">Purchase Date:<\/label><input type=\"date\" name=\"deed_2_purchase_date\" id=\"deed_2_purchase_date\"><\/div>\n\t\t\t<div class=\"epq-field-group\"><label for=\"deed_2_mp\">M\/P:<\/label><input type=\"text\" name=\"deed_2_mp\" id=\"deed_2_mp\"><\/div>\n\t\t<\/div>\n\t\t<div class=\"epq-row\">\n\t\t\t<div class=\"epq-field-group\"><label for=\"deed_2_grantor\">Grantor:<\/label><input type=\"text\" name=\"deed_2_grantor\" id=\"deed_2_grantor\"><\/div>\n\t\t\t<div class=\"epq-field-group\"><label for=\"deed_2_book\">Deed Book:<\/label><input type=\"text\" name=\"deed_2_book\" id=\"deed_2_book\"><\/div>\n\t\t\t<div class=\"epq-field-group\"><label for=\"deed_2_page\">page:<\/label><input type=\"text\" name=\"deed_2_page\" id=\"deed_2_page\"><\/div>\n\t\t<\/div>\n\t<\/div>\n\t\t<div class=\"epq-deed-block\">\n\t\t\t\t\t<hr class=\"epq-deed-separator\">\n\t\t\t\t<div class=\"epq-field-group\"><label for=\"deed_3_street\">Street Address:<\/label><input type=\"text\" name=\"deed_3_street\" id=\"deed_3_street\"><\/div>\n\t\t<div class=\"epq-row\">\n\t\t\t<div class=\"epq-field-group\"><label for=\"deed_3_county\">County:<\/label><input type=\"text\" name=\"deed_3_county\" id=\"deed_3_county\"><\/div>\n\t\t<\/div>\n\t\t<div class=\"epq-row\">\n\t\t\t<div class=\"epq-field-group\"><label for=\"deed_3_city\">City:<\/label><input type=\"text\" name=\"deed_3_city\" id=\"deed_3_city\"><\/div>\n\t\t\t<div class=\"epq-field-group\"><label for=\"deed_3_state\">State:<\/label><input type=\"text\" name=\"deed_3_state\" id=\"deed_3_state\"><\/div>\n\t\t\t<div class=\"epq-field-group\"><label for=\"deed_3_zip\">Zip:<\/label><input type=\"text\" name=\"deed_3_zip\" id=\"deed_3_zip\"><\/div>\n\t\t<\/div>\n\t\t<div class=\"epq-row\">\n\t\t\t<div class=\"epq-field-group\"><label for=\"deed_3_purchase_date\">Purchase Date:<\/label><input type=\"date\" name=\"deed_3_purchase_date\" id=\"deed_3_purchase_date\"><\/div>\n\t\t\t<div class=\"epq-field-group\"><label for=\"deed_3_mp\">M\/P:<\/label><input type=\"text\" name=\"deed_3_mp\" id=\"deed_3_mp\"><\/div>\n\t\t<\/div>\n\t\t<div class=\"epq-row\">\n\t\t\t<div class=\"epq-field-group\"><label for=\"deed_3_grantor\">Grantor:<\/label><input type=\"text\" name=\"deed_3_grantor\" id=\"deed_3_grantor\"><\/div>\n\t\t\t<div class=\"epq-field-group\"><label for=\"deed_3_book\">Deed Book:<\/label><input type=\"text\" name=\"deed_3_book\" id=\"deed_3_book\"><\/div>\n\t\t\t<div class=\"epq-field-group\"><label for=\"deed_3_page\">page:<\/label><input type=\"text\" name=\"deed_3_page\" id=\"deed_3_page\"><\/div>\n\t\t<\/div>\n\t<\/div>\n\t<\/div><div class=\"epq-form-step\" data-step-id=\"7\">\n\t<h2>Review Your Questionnaire<\/h2>\n\t<p>Review the answers below before submitting.<\/p>\n<\/div>\n\t\t\t<\/div>\n\t\t\t\t\t\t<input type=\"hidden\" name=\"epq_form_started_at\" value=\"1782249165\">\n\t\t\t<input type=\"hidden\" name=\"epq_form_start_sig\" value=\"c45879fc247fd62347fdb7c3019e4501\">\n\t\t\t<input type=\"hidden\" id=\"nonce\" name=\"nonce\" value=\"44d57e493b\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/index.php\/wp-json\/wp\/v2\/pages\/7\" \/>\t\t<\/form>\n\n\t\t<div class=\"epq-v2-navigation\">\n\t\t\t<button type=\"button\" class=\"epq-v2-btn epq-v2-btn-secondary\" id=\"epq-v2-prev\">Previous<\/button>\n\t\t\t<button type=\"button\" class=\"epq-v2-btn epq-v2-btn-ghost\" id=\"epq-v2-save\">Save and Resume Later<\/button>\n\t\t\t<button type=\"button\" class=\"epq-v2-btn epq-v2-btn-primary\" id=\"epq-v2-next\">Continue<\/button>\n\t\t\t<button type=\"button\" class=\"epq-v2-btn epq-v2-btn-primary\" id=\"epq-v2-submit\">Submit<\/button>\n\t\t<\/div>\n\t\t<div class=\"epq-v2-footer-links\">\n\t\t\t<button type=\"button\" class=\"epq-v2-back-link\" id=\"epq-v2-back-to-review\" hidden>Back to review screen<\/button>\n\t\t\t<button type=\"button\" class=\"epq-v2-reset\" id=\"epq-v2-reset\">Reset<\/button>\n\t\t<\/div>\n\t<\/div>\n<\/div>\n\n<div id=\"epq-v2-modal-overlay\" class=\"epq-v2-modal-overlay\">\n\t<div id=\"epq-v2-modal-content\" class=\"epq-v2-modal-content\">\n\t\t<button id=\"epq-v2-modal-close\" class=\"epq-v2-modal-close\" type=\"button\">\u00d7<\/button>\n\t\t<h1>Your estate plan document has been sent.<\/h1>\n\t\t<p>The questionnaire PDF was emailed to the addresses you entered and copied to <a href=\"mailto:contactus@gbfoundation.org\">contactus@gbfoundation.org<\/a>.<\/p>\n\t<\/div>\n<\/div>\n\n<div id=\"epq-v2-email-overlay\" class=\"epq-v2-modal-overlay\">\n\t<div id=\"epq-v2-email-content\" class=\"epq-v2-modal-content epq-v2-email-content\">\n\t\t<button id=\"epq-v2-email-close\" class=\"epq-v2-modal-close\" type=\"button\">\u00d7<\/button>\n\t\t<h2 class=\"epq-v2-email-title\">Enter the email addresses to receive your estate plan document.<\/h2>\n\t\t<p class=\"epq-v2-email-intro\">You can enter up to four email addresses.<\/p>\n\t\t<form id=\"epq-v2-email-form\" class=\"epq-v2-email-form\" novalidate>\n\t\t\t<div class=\"epq-v2-email-row-block\">\n\t\t\t\t<label>Your Email Address<\/label>\n\t\t\t\t<div class=\"epq-v2-email-row\">\n\t\t\t\t\t<input type=\"text\" name=\"recipient_name_1\" placeholder=\"Full Name\">\n\t\t\t\t\t<input type=\"email\" name=\"recipient_email_1\" placeholder=\"Email Address\">\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"epq-v2-email-row-block\">\n\t\t\t\t<label>Email 2<\/label>\n\t\t\t\t<div class=\"epq-v2-email-row\">\n\t\t\t\t\t<input type=\"text\" name=\"recipient_name_2\" placeholder=\"Full Name\">\n\t\t\t\t\t<input type=\"email\" name=\"recipient_email_2\" placeholder=\"Email Address\">\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"epq-v2-email-row-block\">\n\t\t\t\t<label>Email 3<\/label>\n\t\t\t\t<div class=\"epq-v2-email-row\">\n\t\t\t\t\t<input type=\"text\" name=\"recipient_name_3\" placeholder=\"Full Name\">\n\t\t\t\t\t<input type=\"email\" name=\"recipient_email_3\" placeholder=\"Email Address\">\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"epq-v2-email-row-block\">\n\t\t\t\t<label>Email 4<\/label>\n\t\t\t\t<div class=\"epq-v2-email-row\">\n\t\t\t\t\t<input type=\"text\" name=\"recipient_name_4\" placeholder=\"Full Name\">\n\t\t\t\t\t<input type=\"email\" name=\"recipient_email_4\" placeholder=\"Email Address\">\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"epq-v2-email-actions\">\n\t\t\t\t<button type=\"submit\" class=\"epq-v2-btn epq-v2-btn-primary\" id=\"epq-v2-email-submit\">Submit<\/button>\n\t\t\t<\/div>\n\t\t\t<div id=\"epq-v2-email-error\" class=\"epq-v2-error\" hidden><\/div>\n\t\t<\/form>\n\t<\/div>\n<\/div>\n\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-7","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/epqreview.gbfoundation.org\/index.php\/wp-json\/wp\/v2\/pages\/7","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/epqreview.gbfoundation.org\/index.php\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/epqreview.gbfoundation.org\/index.php\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/epqreview.gbfoundation.org\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/epqreview.gbfoundation.org\/index.php\/wp-json\/wp\/v2\/comments?post=7"}],"version-history":[{"count":1,"href":"https:\/\/epqreview.gbfoundation.org\/index.php\/wp-json\/wp\/v2\/pages\/7\/revisions"}],"predecessor-version":[{"id":9,"href":"https:\/\/epqreview.gbfoundation.org\/index.php\/wp-json\/wp\/v2\/pages\/7\/revisions\/9"}],"wp:attachment":[{"href":"https:\/\/epqreview.gbfoundation.org\/index.php\/wp-json\/wp\/v2\/media?parent=7"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}