A FIRM DEDICATED TO ELDER LAW AND SPECIAL NEEDS PLANNING

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QUESTIONNAIRE

Please complete this questionnaire prior to our consultation. The more accurate and complete you answer the questions, the more productive our meeting will be.

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List the value of each of the assets (including liabilities) of the chronically ill elder , if any, as described below: Indicate if jointly owned and with whom.

List the value of the assets (including liabilities) for the spouse of the chronically ill elder, if any, as described below: Indicate if jointly owned and with whom.

Please list all household expenses on a monthly basis as described below:

MIAMI OFFICE

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PHONE: (305) 274-0955

 

E-MAIL: lenlaw1@aol.com

AVENTURA OFFICE

20801 BISCAYNE BOULEVARD

SUITE 403

AVENTURA, FLORIDA 33180

 

PHONE: (305) 274-0955

 

E-MAIL: lenlaw1@aol.com

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