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Firm Phone(Required)
First Middle Last
J.D. Esq. LL.M.
Attorney Bio(Required)Attorney biography to be listed on SimpleWill Attorney Headshot(Required)Headshot to be used on SimpleWill.Accepted file types: jpg, png, jpeg, Max. file size: 5 MB.Attorney Signature(Required)Image to use for attorney signature on SimpleWill. Transparent background recommended.Accepted file types: jpg, png, jpeg, Max. file size: 5 MB.Attorney Email Address(Required)Email address to use for SimpleWill account & notifications Attorney Phone Number(Required)Phone number to be listed on SimpleWill and in documents.
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 Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Armed Forces Americas Armed Forces Europe Armed Forces Pacific
Yes No
Enter the state bar association and Supreme Court Bar Number(Required) Logo(Required)Logo to be used on SimpleWill. Logo must have a transparent background.Accepted file types: jpg, png, jpeg, Max. file size: 5 MB.E&O Insurance(Required)Please upload a copy of your E&O insurance. Max. file size: 5 MB.Price of Individual Plan(Required)Price of Family Plan(Required)
Please list the discount options you would like to have available. Example: Half off, 50Off, 50% $100 Discount, ABC123, $100Discount NameDiscount CodeDiscount % or Value Add Remove
A LawPay account is required to use SimpleWill. If “no” is selected, a representative will contact you to assist in setting up a LawPay account. Yes No
Part of the automation process for SimpleWill is providing a link to clients to schedule their meeting with their selected attorney. SimpleWill does not provide this software, but can help setup and configure them. Please select if you have a booking link below, if not, we recommend Microsoft Bookings (included with Office365 services) or Cal.com for this service (we recommend these providers because they directly include video conferencing links automatically). We will need to collect a booking URL link to complete setup of your SimpleWill account. If “no” is selected, a representative will contact you to assist in obtaining this URL. Yes No
Calendar Booking Software URL(Required)
Opt to enroll in the Employer Referral Network program offered by SimpleWill which allows SimpleWill licensees to have an opportunity to be exposed to and procure a new client base derived from interested, motivated employees throughout the state who have enrolled in the SimpleWill estate planning employee benefit product offered by JTS Financial. Fees for the employee benefit product shall be offered at $249.00 for an employee and $379.00 for an employee and spouse. Yes No
Please review the Employer Referral Network Licensing Agreement: LICENSING AGREEMENT
Please review the Licensing Agreement: LICENSING AGREEMENT
I have reviewed and agree with the licensing agreement I agree
Authorized Representative Email(Required)
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Authorized Representative Title(Required) Authorized Representative Signature(Required)