Bossmaker Syndicate Onboarding Survey

1

Participant

First Name *

Middle Name

Last Name *

Date of Birth *

State *

Driver License / ID *

SSN *

Phone *

Email *

2

Trust and Grantor

Requested Trust Name *

Independent Grantor Legal Name *

Grantor Relationship

Grantor SSN *

Grantor Email *

Grantor Phone *

Grantor Street Address *

City *

State *

Zip *

3

Witnesses

Please provide your 2 witnesses so we can add them to the digital signing ceremony.

1st Witness Name *

1st Witness Phone Number *

1st Witness Email *

1st Witness Address *

2nd Witness Name *

2nd Witness Phone Number *

2nd Witness Email *

2nd Witness Address *

4

Name Your Wyoming Holding Company

(Do not name it anything related to any business related/attached to you.)

Name of New Wyoming Holding CO *

5

Beneficiaries

6

Agents and Fiduciaries

Primary Financial Agent First Name *

Primary Financial Agent Last Name *

Primary Financial Agent Phone

Successor Financial Agent *

Estate Executor

Healthcare & HIPAA Agent

Healthcare Agent First

Healthcare Agent Last

Digital Asset Fiduciary

Digital Fiduciary First

Digital Fiduciary Last

Minor Guardian