Trusted Agents Consent Form

We are pleased that you are interested in retaining the services of NC Planning, a service of Lenfestey, Maxie & Burger, PLLC. In our efforts to be of assistance to you and to gather all necessary information for properly coordinating your planning, we wish to obtain your informed consent to contact and communicate with the below named individuals or institutions in order to proceed with your matter.

By signing below, you hereby agree (i) that you and NC Planning benefit from the assistance of the below named trusted individuals, and (ii) that you consent to NC Planning communicating with the below named trusted agents for the sole purpose of furthering your planning process.

My Information *

	First Name	Last Name	Phone	Email
1.	First Name	Last Name	Phone	Email

My Partner/Spouse

	First Name	Last Name	Phone	Email
1.	First Name	Last Name	Phone	Email

Trusted Agents:

	Name/Institution	Relationship	Contact
1.	Name/Institution	Relationship	Contact
2.	Name/Institution	Relationship	Contact
3.	Name/Institution	Relationship	Contact
4.	Name/Institution	Relationship	Contact
5.	Name/Institution	Relationship	Contact

I agree to the above named agents receiving information from NC Planning

Signature *

clear

Spouse Signature

clear

Date Signed *