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DURRELL LAW GROUP, P.C.
1400 West Benson Blvd.
Suite 370
Anchorage, Alaska 99503
907 258.3224 Main
907 258.3229 Fax  
info@durrell.com

Contact Information Update Form

Client Information

Marital Status

Not Married Married Life Partner

Full Name

Spouse

Life Partner

Primary Location and Contact Information

Location	Home Work
Address 1
Address 2
City
State	Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Oklahoma Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
Zip

Phone		Select Location Home Work Not Applicable (None)
Cell
Fax		Select Location Home Work Not Applicable (None)
Email*

Phone		Select Location Home Husband Work Wife Work Not Applicable (None)
Cell		Select Owner Husband Wife Not Applicable (None)
Fax		Select Location Home Husband Work Wife Work Not Applicable (None)
Email*

Phone		Select Location Home Client Work Life Partner Work Not Applicable (None)
Cell		Select Owner Client Life Partner Not Applicable (None)
Fax		Select Location Home Client Work Life Partner Work Not Applicable (None)
Email*

Secondary (Alternate) Contact Information

Phone		Select Location Home Work Not Applicable (None)
Fax		Select Location Home Work Not Applicable (None)
Email

Phone		Select Location Home Husband Work Wife Work Not Applicable (None)
Cell		Select Owner Husband Wife Not Applicable (None)
Fax		Select Location Home Husband Work Wife Work Not Applicable (None)
Email

Phone		Select Location Home Client Work Life Partner Work Not Applicable (None)
Cell		Select Owner Client Life Partner Not Applicable (None)
Fax		Select Location Home Client Work Life Partner Work Not Applicable (None)
Email

Instructions for Handling of Purged Original Documents

How would you like us to handle the original documents to be removed from the vault (listed in the email)?

Select One

	Please send me the purged documents
	Please shred the purged documents

Instructions for Handling of Original Estate Planning Documents

Select One

	Please continue to hold my original estate planning documents in your vault.
	Thanks, but I no longer desire for you to hold our original documents. Please send them to me at the address reflected above.
	The original documents in your vault have been revoked. I direct that you shred them.
	Please contact me to discuss what documents are being held in your vault.
	Please contact me to schedule an appointment to review and possibly update my estate plan.

	Please continue to hold our original estate planning documents in your vault.
	Thanks, but we no longer desire for you to hold our original documents. Please send them to us at the address reflected above.
	The original documents in your vault have been revoked. We direct that you shred them.
	Please contact us to discuss what documents are being held in your vault.
	Please contact us to schedule an appointment to review and possibly update our estate plan.

Questions or Comments

If you have any questions or comments please list them below.

1400 West Benson Blvd., Suite 370
Anchorage, Alaska 99503
907 258.3224 Main 
907 258.3229 Fax   
info@durrell.com  

Designed by Kathleen Y. Lawyer
Staff Photos by Daryl Pederson, D&M Photo Studio
Last updated on June 05, 2009 07:41 PM