Living Trust Application

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Welcome!

This Living Trust Application should take about 30–40 minutes to complete. Fill this form out as thoroughly as you can — but don’t worry if you’re unsure about something. You will have a chance to review everything during the design meeting with your BCN Advisor before anything is finalized.

To help guide you, we’ve included short videos and explanations throughout the application that explain each section.

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Enter the "Last Name(s)" of Your Living Trust

Which BCN advisor are you working with?

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Settlor's Information

This is you, the individual that is establishing the trust

Spouse 1

First Name

Middle Name

Last Name

Suffix

Address

Address Line 1

Address Line 2

City

State

Zip Code

Birthdate

Social Security Number

Phone

Gender

Male
Female

Do you have a spouse? *

Date Of Marriage

Do you have minor children? (Under Age 18) *

Spouse 2

First Name

Middle Name

Last Name

Suffix

Address

Address Line 1

Address Line 2

City

State

Zip Code

Birthdate

Social Security Number

Phone

Gender

Male
Female

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Primary Beneficiary Designations

Please list the full names, addresses, and phone numbers of each individual or organization you wish to name as a beneficiary.

Your Successor Trustee will divide the remaining assets — including principal, income, and any unallocated property — according to your chosen distribution method and the instructions you provide here

Beneficiary

First Name

Middle Name

Last Name

Birth Date

Phone

Relationship:

Relation To:

Address

Address Line 1

Address Line 2

City

State

Zip Code

Comments:

By default, your estate plan will divide the value of your estate equally among all listed beneficiaries. If you would like this beneficiary to receive an unequal share or a specific percentage of your estate, please indicate that here.

Structure of Distribution:

Please choose how you would like your beneficiary to receive their inheritance. You may distribute their entire share at once (an 'outright distribution') or spread the distributions out over time by specifying particular ages or milestones.

Gender

Male
Female

Special Needs Individual?

Yes, Please Include a "Special Needs Provision"

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Successor Trustee Information

This is the individual that is responsible for enforcing the trust

A successor trustee is the person you name to manage your trust after both you and your spouse pass away. They handle your assets, pay bills, take care of taxes, and distribute everything to your beneficiaries according to your instructions. They may also manage investments or sell property if needed.

This person should be responsible, organized, and able to follow your wishes closely. Many people choose a spouse, adult child, close friend, or a trusted professional like a CPA or attorney. The successor trustee makes sure your plan is carried out when you no longer can.

1st Successor Trustee

First Name

Middle Name

Last Name

Gender

Male
Female

Address

Address Line 1

Address Line 2

City

State

Zip Code

Birth Date

Phone

Relationship:

Relation To:

Alternate Successor Trustee

First Name

Middle Name

Last Name

Gender

Male
Female

Address

Address Line 1

Address Line 2

City

State

Zip Code

Birth Date

Phone

Relationship:

Relation To:

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Contingent Beneficiaries

Contingent beneficiaries are your backups—they receive their share only if your primary beneficiaries are unable.

Contingent beneficiaries are your backups. They only inherit your estate if all of your primary beneficiaries have passed away or are unable to receive their share. Naming them ensures your assets are still distributed according to your wishes, even if your first choices aren’t available.

Contingent Beneficiary

First Name

Middle Name

Last Name

Gender

Male
Female

Address

Address Line 1

Address Line 2

City

State

Zip Code

Birth Date

Phone

Relationship:

Relation To:

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"Excluded" Beneficiaries

Individuals you wish to specifically exclude from receiving distributions

If there’s anyone you want to exclude from receiving anything from your trust, you can list them here with a brief explanation. This helps ensure your Trustee clearly understands and follows your wishes.

Only fill out this section if it applies to you. If not, feel free to leave it blank.

Excluded Beneficiary

First Name

Middle Name

Last Name

Gender

Male
Female

Address

Address Line 1

Address Line 2

City

State

Zip Code

Birth Date

Phone

Relationship:

Relation To:

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Please List any (Deceased) Children

We ask about any deceased children to ensure your estate plan reflects the correct distribution of assets, including provisions for their descendants (if any), and to avoid future complications or disputes.

Deceased Child

First Name

Middle Name

Last Name

Gender

Male
Female

Birth Date

Date of Death

Relationship:

Relation To:

Did this child have any children who are still living?

If yes, and you wish to leave a distribution to this child’s descendants, please include them in section 3 or section 5 of this form.

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Guardian(s) For Minor Children

This is the individual you choose to care for your minor children — providing day-to-day support, making medical and educational decisions, and raising them if you’re no longer able to.

Notice: The "Guardian(s) for Minor Children" Section is Not Required

**“You indicated in Section 2 that you do not have minor children. Because of this, the guardianship section does not apply and can be skipped. Please click NEXT to continue.

If this was selected in error, you may return to Section 2 and update your response to show that you do, in fact, have minor children.”**

Gender Alternate Policy

"The Guardian for Minor Children," or "Guardian of the Person" is someone you designate to care for your minor children if you pass away while they’re still underage. This person takes on full parenting responsibilities — providing a home, making medical and educational decisions, and guiding them through daily life.

You’re naming someone a court can officially appoint to raise your children in your absence. While the court makes the final decision, your wishes carry significant weight. Choose someone loving, dependable, and aligned with your values. Naming a guardian in advance gives your children stability — and ensures their future is guided by someone you trust.

Guardians for Minor Children (Successor Order)

"Use Successor Trustee(s) as Guardian(s)"

The successor trustees you've listed above, in the same order, have been applied as the guardian(s) in this section.

1st Guardian

First Name

Middle Name

Last Name

Gender

Male
Female

Address

Address Line 1

Address Line 2

City

State

Zip Code

Birth Date

Phone

Relationship:

Relation To:

Alternate Guardian

First Name

Middle Name

Last Name

Gender

Male
Female

Address

Address Line 1

Address Line 2

City

State

Zip Code

Birth Date

Phone

Relationship:

Relation To:

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Guardian(s) Ad Litem

Individuals appointed to represent the legal interests of a minor or incapacitated beneficiary

Notice: The "Guardian(s) Ad Litem" Section is Not Required

You have indicated in Section 2 that you do not have minor children. As a result, this section does not apply and may be disregarded. Please press Continue to proceed.

If this was selected in error, you may return to Section 2 and update your response to indicate that you do, in fact, have minor children.

A guardian ad litem is someone a court may appoint to represent the best interests of a minor or incapacitated beneficiary during a legal proceeding involving your trust. They don’t take custody or manage money — they simply speak for and protect the beneficiary’s legal interests if a court process is ever required.

You’re naming someone the court should consider if the need arises. While a judge must still formally appoint them, courts often respect your recommendation. Choose someone trustworthy, objective, and ideally not directly benefiting from the trust. This role only applies if a legal issue comes up, but naming someone in advance helps protect your most vulnerable beneficiaries.

Guardians Ad Litem (Successor Order)

"Use Successor Trustee(s) as Guardian(s) Ad Litem"

1st Guardian Ad Litem

First Name

Middle Name

Last Name

Gender

Male
Female

Address

Address Line 1

Address Line 2

City

State

Zip Code

Birth Date

Phone

Relationship:

Relation To:

Alternate Guardian Ad Litem

First Name

Middle Name

Last Name

Gender

Male
Female

Address

Address Line 1

Address Line 2

City

State

Zip Code

Birth Date

Phone

Relationship:

Relation To:

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Health Care Agents

The Individuals you authorize to make medical decisions on your behalf if you become incapacitated

Your health care agent makes medical decisions if you’re unconscious or unable to speak for yourself. This can include treatment, medications, surgery, end-of-life care, or choosing a care facility. They only act when you can’t, and they’re required to follow your written wishes and values as closely as possible.

Typically, your spouse is named first, followed by the same individuals listed as your Successor Trustees and Financial Agents, keeping your plan consistent. Without this, your family could face delays or conflict during a medical crisis. Choose someone calm under pressure, who can clearly communicate with doctors and advocate for your wishes — even when it’s hard.

Spouse 1: Health Care Agent(s)

Typically, the Grantor's Spouse is primary POA, followed by 2 trusted alternates

Spouse 1: Spouse as Primary Health Care Agent

Use Spouse as "Primary Health Care Agent"

Spouse 1: Trustees as Health Care Agents

Use Successor Trustee(s) as "Health Care Agent(s)"

Spouse 1: Trustees as Alternate Health Care Agents

Use Successor Trustee(s) as "Alternate Health Care Agent(s)"

"Please note: If you would like to designate your spouse as the primary Agent AND your successor trustees (in the listed order) as alternates....Please Double check you have selected both checkboxes above.

You DO NOT need to complete the section below.

Spouse 1: Primary Health Care Agent

First Name

Middle Name

Last Name

Gender

Male
Female

Address

Address Line 1

Address Line 2

City

State

Zip Code

Birth Date

Phone

Relationship:

Relation To:

Spouse 1: Alternate Health Care Agent

First Name

Middle Name

Last Name

Gender

Male
Female

Address

Address Line 1

Address Line 2

City

State

Zip Code

Birth Date

Phone

Relationship:

Relation To:

Spouse 2: Health Care Agent(s)

Typically, the Grantor is primary POA, followed by 2 trusted alternates

Spouse 2: Spouse as Primary Health Care Agent

Use Spouse as "Primary Health Care Agent"

Spouse 2: Trustees as Alternate Health Care Agent(s)

Use Successor Trustee(s) as "Alternate Health Care Agent(s)"

You DO NOT need to complete the section below.

Spouse 2: Primary Health Care Agent

First Name

Middle Name

Last Name

Gender

Male
Female

Address

Address Line 1

Address Line 2

City

State

Zip Code

Birth Date

Phone

Relationship:

Relation To:

Spouse 2: Alternate - Health Care Agent

First Name

Middle Name

Last Name

Gender

Male
Female

Address

Address Line 1

Address Line 2

City

State

Zip Code

Birth Date

Phone

Relationship:

Relation To:

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Financial Power of Attorney

The Individual(s) who make financial decisions on your behalf if you are unable to do so yourself

A financial power of attorney lets someone you trust manage your finances if you can’t — due to illness, injury, or incapacity. They can pay bills, manage accounts, handle taxes, and even sell property or oversee investments, depending on the authority you give. This role can begin right away or only if you're declared incapacitated.

In most cases, your spouse is named as the primary agent, followed by the same individuals listed as Successor Trustees and Health Care Agents, keeping your plan simple and consistent. Without this document, your loved ones may have to go through court to act on your behalf. Choosing someone responsible and financially capable ensures your affairs are handled the way you’d want.

Spouse 1: Financial - Power of Attorney Agent(s)

Typically, Spouse 2 is the Primary Power of Attorney, followed by 2 trusted alternates

Spouse 1: Spouse as Primary POA Agent

Please use my Spouse as my "Primary - Financial Power of Attorney"

Spouse 1: (Single Trust) Use Successor Trustees as Financial POA Agents

Please use the order of my Successor Trustee(s) as my "Financial Power of Attorney Agent(s)"

Spouse 1: Use Successor Trustee Order as backup "Financial POA""

And, please use my Successor Trustee(s) as my "Alternate - Financial Power of Attorney Agent(s)"

"Please note: If you would like to designate your spouse as the primary trustee AND your successor trustees (in the listed order) as alternates....Please Double check you have selected both checkboxes above.

You DO NOT need to complete the section below.

Please Note: If you would like to designate your successor trustee(s), in the order you have listed them, as your "Financial Power Of Attorney Agents....."

You DO NOT need to fill out this section

Spouse 1: Primary - Financial Power of Attorney

First Name

Middle Name

Last Name

Gender

Male
Female

Address

Address Line 1

Address Line 2

City

State

Zip Code

Birth Date

Phone

Relationship:

Relation To:

Spouse 1: Alternate - Financial Power of Attorney

First Name

Middle Name

Last Name

Gender

Male
Female

Address

Address Line 1

Address Line 2

City

State

Zip Code

Birth Date

Phone

Relationship:

Relation To:

Spouse 2: Financial - Power of Attorney Agent(s)

Typically, Spouse 1 is the Primary Power of Attorney, followed by 2 trusted alternates

Spouse 2: Spouse as Primary Financial Power of Attorney

Please use my Spouse as my "Primary - Financial Power of Attorney"

Spouse 2: Use Successor Trustee Order as "Financial POA"

And, please use my Successor Trustee(s) as "Alternate - Financial Power of Attorney Agent(s)"

"Please note: If you would like to designate your spouse as the primary trustee and your successor trustees (in the listed order) as alternates....Please Double check you have selected both checkboxes above.

You DO NOT need to complete the section below.

Spouse 2: Primary - Financial Power of Attorney

First Name

Middle Name

Last Name

Gender

Male
Female

Address

Address Line 1

Address Line 2

City

State

Zip Code

Birth Date

Phone

Relationship:

Relation To:

Spouse 2: Alternate - Financial Power of Attorney

First Name

Middle Name

Last Name

Gender

Male
Female

Address

Address Line 1

Address Line 2

City

State

Zip Code

Birth Date

Phone

Relationship:

Relation To:

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Pour-Over Will

The backup document that ensures any assets not placed in your trust are transferred into it after your death.

A pour-over will is a backup document that works with your trust. It’s meant to catch anything you forgot to transfer — like a bank account or vehicle — and move it into your trust after you pass. While it goes through probate, it ensures your assets still follow your trust instructions.

Even with good planning, things can get missed. Without this will, any assets left out of your trust could be distributed under state law, not your wishes. This document helps prevent that.

Your Executor handles this process by working with the court and making sure missed assets are moved into your trust. Typically, your spouse is named first, followed by the same people listed as Successor Trustees and Agents under your Powers of Attorney — keeping your plan simple and consistent.

Spouse 1: Executor(s)

Typically, Spouse 2 is the Primary Executor; followed by 2 trusted alternates

Spouse 1: Use Spouse as "Primary Executor"

Use Spouse as "Primary Executor"

Spouse 1: Use my Successor Trustee(s) as Power-of-Attorney "Executors"

Use Successor Trustee(s) as "Alternate - Financial Power of Attorney Agent(s)"

Spouse 1: Use Successor Trustee(s) as "Alternate Executors"

Use Successor Trustee(s) as "Alternate - Executor(s)"

You DO NOT need to complete the section below.

Please Note: If you would like to designate your successor trustee(s), in the order you have listed them, as your "Financial Power Of Attorney Agents....."

You DO NOT need to fill out this section

Spouse 1: Primary Executor

First Name

Middle Name

Last Name

Gender

Male
Female

Address

Address Line 1

Address Line 2

City

State

Zip Code

Birth Date

Phone

Relationship:

Relation To:

Spouse 1: Alternate Executor

First Name

Middle Name

Last Name

Gender

Male
Female

Address

Address Line 1

Address Line 2

City

State

Zip Code

Birth Date

Phone

Relationship:

Relation To:

Spouse 2: Executor(s)

Typically, Spouse 1 is the Primary Executor; followed by 2 trusted alternates

Spouse 2: Use Spouse as "Primary Executor"

Please use my Spouse as the "Primary Executor"

Spouse 2: Use Successor Trustee(s) as "Alternate Executors" (copy)

And, Please use my Successor Trustee(s) as my "Alternate - Executor(s)"

You DO NOT need to complete the section below.

Spouse 2: Primary Executor

First Name

Middle Name

Last Name

Gender

Male
Female

Address

Address Line 1

Address Line 2

City

State

Zip Code

Birth Date

Phone Number

Email Address

Relation To:

Spouse 2: Alternate Executor

First Name

Middle Name

Last Name

Gender

Male
Female

Address

Address Line 1

Address Line 2

City

State

Zip Code

Birth Date

Phone

Relationship:

Relation To:

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Personal Property & Assets

Community Property, Separate Property & Funding

A Quick Note:

You're now entering the final section of your trust. This part covers financial accounts, retirement plans, life insurance policies, checking and savings accounts, and real estate holdings. Please complete this section as accurately as possible — the information you provide ensures your trust is properly prepared and your assets are fully protected.

California is a community property (CP) state, meaning most assets acquired during marriage are shared. Separate property (SP) includes anything owned before marriage or received as a gift or inheritance, if kept separate. When listing your assets, mark each one as CP or SP, indicate Spouse 1 (S1) or Spouse 2 (S2) for SP, and include an estimated value.

Upload Your California Driver's License(s)

Spouse 1: California Drivers License *

Drag & Drop Files, Choose Files to Upload

Spouse 2: California Drivers License *

Drag & Drop Files, Choose Files to Upload

Real Estate Property

List any ownership interest in real estate including your primary residence, investment property, timeshare, vacant land, or other. If you have it, provide the grant deed for each property (usually 2-5 pages long and includes a legal description in “exhibit A.”).

Property Type

Ownership

Address

Approximate Home Value

Bank / Cash Accounts

List all checking accounts, savings accounts, certificates of deposits, or money market. If an account is in your name (or your spouse’s name) for the benefit of a minor (checking, savings, 529, etc.), please specify and give the minor’s name.

Account Type

Ownership

Account Number

Approximate Value

Name of Institution

Investment Accounts

Stocks, bonds, mutual funds, and brokerage accounts

Account Type

Ownership

Account Number

Approximate Value

Name of Institution

Retirement Accounts

List all IRA, Roth IRA, 401(k), 457(b), 403(b), etc. For each retirement plan, list which spouse owns the plan, the type of plan, current value of the plan, and current beneficiary(s).

Account Type

Ownership

Account Number

Approximate Value

Name of Institution

Life Insurance Policies

List all term, Permanent life, annuity, etc. For each policy listed, indicate the insurance company, type of policy, whose life is insured, face amount (death benefit), and current beneficiary(s).

Policy Type

Insured Person

Policy Number

Death Benefit

Insurance Company

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Los Angeles, USA

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BCN FinancialBenefits Communication Network(510) 769-1088

BCN Financial, Inc.

Investment Advisor

Phone 510-769-1088Fax 510-769-8980

Email [email protected]

Business Address

3215 Encinal Ave, Suite L
Alameda, CA 94501

Mailing Address

909 Marina Village Pkwy
PMB 245
Alameda, CA 94501

LPL Financial, LLC

Broker-Dealer

Phone 1 (800) 558-7567Fax 1 (858) 202-8500

Email [email protected]

Business Address

4707 Executive Drive
San Diego, CA 92121

Mailing Address

1055 LPL Way
Attn: Trade Direct
Fort Mill, SC 29716

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Living Trust Application

Settlor's Information

Spouse 1

Spouse 2

Primary Beneficiary Designations

Beneficiary

Successor Trustee Information

1st Successor Trustee

Alternate Successor Trustee

Contingent Beneficiaries

Contingent Beneficiary

"Excluded" Beneficiaries

Excluded Beneficiary

Please List any (Deceased) Children

Deceased Child

Guardian(s) For Minor Children

Notice: The "Guardian(s) for Minor Children" Section is Not Required

1st Guardian

Alternate Guardian

Guardian(s) Ad Litem

Notice: The "Guardian(s) Ad Litem" Section is Not Required

1st Guardian Ad Litem

Alternate Guardian Ad Litem

Health Care Agents

Spouse 1: Health Care Agent(s)

Spouse 1: Primary Health Care Agent

Spouse 1: Alternate Health Care Agent

Spouse 2: Health Care Agent(s)

Spouse 2: Primary Health Care Agent

Spouse 2: Alternate - Health Care Agent

Financial Power of Attorney

Spouse 1: Financial - Power of Attorney Agent(s)

Spouse 1: Primary - Financial Power of Attorney

Spouse 1: Alternate - Financial Power of Attorney

Spouse 2: Financial - Power of Attorney Agent(s)

Spouse 2: Primary - Financial Power of Attorney

Spouse 2: Alternate - Financial Power of Attorney

Pour-Over Will

Spouse 1: Executor(s)

Spouse 1: Primary Executor

Spouse 1: Alternate Executor

Spouse 2: Executor(s)

Spouse 2: Primary Executor

Spouse 2: Alternate Executor

Personal Property & Assets

A Quick Note:

Upload Your California Driver's License(s)

Real Estate Property

Bank / Cash Accounts

Investment Accounts

Retirement Accounts

Life Insurance Policies

BCN Financial INC

LPL Financial, LLC

Form ADV Part 2

Enfold BB

BCN Financial, Inc.

Business Address

Mailing Address

LPL Financial, LLC

Business Address

Mailing Address

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