ESTATE PLANNING QUESTIONNAIRE

INTRODUCTION:

The following form is to fill in before you see your attorney for your estate planning. It will save an hour or so of time in which you answer questions if you first prepare the following answers to the questions propounded but simply filling in the form will not avoid the necessity of meeting and conferring with counsel. Any good estate planner will still have many questions to propound about your needs and wishes and the unique circumstances in your family that may require particular plans.

Be sure to read the articles on this website on wills and trusts as well as on living wills before answering the questions below. Once you have filled in the form, either fax it to your attorney before the meeting or take it with you. Each person needing a Will or Trust should fill in their own form.

INFORMATION NEEDED FOR WILL, TRUST AND RELATED DOCUMENTS

Please provide the following information to assist us in analyzing what is the best estate plan for your particular circumstances and in preparing the relevant documents:

1. PERSONAL INFORMATION:

CLIENT

Name:
___________________________________________________________________________________

Address:
___________________________________________________________________________________

Citizenship:
___________________________________________________________________________________

Business name and address:
___________________________________________________________________________________

Social security number:
___________________________________________________________________________________

Phone number(s):
___________________________________________________________________________________

Fax number:
___________________________________________________________________________________

E-mail:
___________________________________________________________________________________

Date of birth:
___________________________________________________________________________________

Place of Birth:
___________________________________________________________________________________

Date and Place of Marriage:
___________________________________________________________________________________

Do you have a prenuptial agreement?
___________________________________________________________________________________

For any previous marriages, provide name of prior spouse and date of dissolution of marriage if applicable:
___________________________________________________________________________________

If terminated by death, provide prior spouse's full name, date and place of death:
___________________________________________________________________________________

SPOUSE

Name of Spouse:
___________________________________________________________________________________

Date of Birth and Place of Birth:
___________________________________________________________________________________

Citizenship:
___________________________________________________________________________________

Social Security Number:
___________________________________________________________________________________

For any previous marriages, provide name of prior spouse and date of dissolution of marriage if applicable:
___________________________________________________________________________________

If terminated by death, provide prior spouse's full name, date and place of death:
___________________________________________________________________________________
___________________________________________________________________________________

CHILDREN:

Name(s), Birth Dates, and Places of Birth of Children:
___________________________________________________________________________________
___________________________________________________________________________________

Deceased Children?
___________________________________________________________________________________
___________________________________________________________________________________

Spouses of Children?
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________

Deceased Spouses of Children?
___________________________________________________________________________________
___________________________________________________________________________________

PARENTS AND SIBLINGS:

Names of Parents, ages and addresses:
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________

Names of siblings and their addresses:
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________

Guardians for Minor Children: Please provide names, addresses, relationship for first choice and second choice:
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________

Who Should Be Your Guardian if you are Incompetent?
___________________________________________________________________________________
___________________________________________________________________________________

If You And Your Spouse are Both Incompetent, Who Should Take Care of Your Affairs?
___________________________________________________________________________________
___________________________________________________________________________________

2. FINANCIAL INFORMATION:

ASSETS:

Real property: (List Address of each property and how title is held - Please provide a copy of deed for each property)
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________

Cash: (List checking and saving accounts numbers with bank and branch address information, CD accounts with account numbers, institution and address information; money market accounts with account numbers, institution and address information)
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________

Securities: (List stocks, bonds, amounts, how title held and brokerage accounts with account information)
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________

Business interest: (Sole proprietorship, partnerships, LLCs or corporations - Name of the Business, Address, your interest & estimated value)
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________

Buy and Sell? _________________________________

Retirement : (Pension, IRA's, Keough's account information, value and current beneficiaries)
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________

Life insurance policies: (Policy numbers, amounts and beneficiaries)
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________

Death Benefit Policies of Any Kind?
___________________________________________________________________________________

Ownership of any Intellectual Property: (copyrights, patents or trademarks)
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________

Beneficial interest in trust:
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________

Car(s):
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________

Miscellaneous: jewelry, furniture, art, collections:
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________

Others: lawsuits, judgments
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________

Income: present and projected
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________

Liabilities: secured and unsecured obligations
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________

3.EXISTING ESTATE PLAN DOCUMENTS, IF ANY: (wills, trusts)
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________

4.TRUST: (Issues to discuss and determine)
Tax Savings/Probate Avoidance Important? (Estates over one million dollars must take into account estate tax issues.) _________________________

Trustees and successor trustees and powers of trustees: (Names and Addresses of trustee and at least two successor trustees)
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________

Distributive wishes: Income: beneficiaries and successor or alternate beneficiaries
Principal beneficiaries and successor or alternate beneficiaries
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________

Age or other restrictions to distributions__________________________________

Assets to be placed in the trust
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________

4. TESTAMENTARY WISHES:

Specific gifts:
___________________________________________________________________________________
___________________________________________________________________________________

Personal belongings:
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________

Monetary gifts:
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________

Residue: beneficiaries and contingent beneficiaries
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________

Gift in Trust
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________

Executors and alternate executors: Names and Addresses of executor and two alternates
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________

5. OTHER DOCUMENTS:

Durable Power of Attorney for Assets: Name and Address of Agent and 2 alternates:

Extent of Power:

Springing (i.e. upon incapacity) or Immediate:_______________

Advanced Health Care Directive: Name of Agent and alternate agents
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________

Marital Property Agreement
Community and separate property of spouses
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________

Special Concerns for Estate Planning (sick elderly parent; disabled child?
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________

Property abroad? Desire for Charitable giving? Etc?:
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________