General Information
Your full legal name
N.C. County where you live
Your address
Your phone number   Email address
Your spouse's full legal name
Full legal names & birth dates of your children

Do You Want A Simple Will? ($150 for one, $200 for a married couple)
Do you want to leave all your property to your spouse?yes  no NA
Do you want your children to share your property equally if your spouse
    (if living) does not survive you? yes   no na
If any of your children are under age 18, do you want to name a guardian
    for them?  yes   no  None under 18
    If so, the guardian's full name
Who do you want to settle your estate?  (We suggest your spouse, if any,
    as your first choice) 1st choice   
                                       2nd choice 

Do You Want a General Power of Attorney? ($50 for one, $75 for a
     married couple)  A power of attorney is a legal document that allows someone designated by you to handle your affairs.  It is especially helpful to have one if you should become incompetent or unable to handle your own affairs for any reason.
    Yes No
Who do you want to take charge of your property and legal affairs if
    necessary? We suggest your spouse (if any) as your first choice.
    1st choice 2nd choice

Do You Want a Living Will? ($40 for one, $65 for a married couple)  A living will is an advance direction to your family and doctors that you do not want your life prolonged unnecessarily.   
    Yes    No
The general information above is sufficient.

Do You Want a Health Care Power of Attorney? ($50 for one, $75 for
      a married couple)  A health care power of attorney is similar to a general power of attorney, but it only gives someone else authority to make decisions regarding any health care you might need.
    Yes  No

Who do you want to name to make health care decisions for you if
     necessary?
     His/her mailing address
Do you want to designate a specific doctor to participate in your health care
     decisions? (We include "any attending physician")  yes no
If so, full name and address 

Payment Method
You can pay by credit card (either on-line, by phone, or by mail) or by
      check or money order mailed to us.
Credit card:  VISA  Master Card   Expires (month/year)
      Name shown on card
      Credit Card Number 
OR Mail your check, money order, or credit card information to Stephen L. Beaman, PLLC,  P.O. Box 1907,  Wilson, NC 27894-1907
OR Call your credit card information to us at 252-237-9020