Estate Questionnaire

Step 1 of 6

Children and Beneficiaries
Full Legal Name
First Last
Preferred Name
First Last
Relationship
Relationship (e.g. child of H or W or both, adopted, step-child, grandchild, etc.):
DOB
MM slash DD slash YYYY
U.S. Citizen?
- Yes
- No
Spouse's Name
First Last
Children's Names:
Inheritance Instrucions
Specific Instructions Regarding Inheritance:
Additional Comments
(e.g. special needs):

Designated Persons
In this section, please identify the persons designated to act on your behalf in the listed capacities.
Executor: An executor is the person named in your will who is given the legal responsibility to administer your estate and take care of your remaining financial obligations.
Husband First Choice
Relationship to Husband
Husband 1st Alt. Executor
Relationship to Husband
Husband 2nd Alt. Executor
Relationship to Husband
Wife First Choice
Relationship to Wife
Wife 1st Alt. Executor
Relationship to Wife
Wife 2nd Alt. Executor
Relationship to Wife
Trustee for Minor Children Trust: Your will may include provisions putting assets to be disbursed to minor children into trust until they reach a determined age. The named trustee will administer the trust assets in accordance with the will.
Husband First Choice
Relationship to Husband
Husband 1st Alt. Executor
Relationship to Husband
Husband 2nd Alt. Executor
Relationship to Husband
At what age would you like assets distributed in full to your children?
(e.g. 18, 25, etc.)
Wife First Choice
Relationship to Wife
Wife 1st Alt. Executor
Relationship to Wife
Wife 2nd Alt. Executor
Relationship to Wife
At what age would you like assets distributed in full to your children?
(e.g. 18, 25, etc.)
Guardian: The will should identify one or more persons to serve as guardian of any minor children if you and your spouse pass away. Doing so allows you to make this decision, rather than leaving it in the hands of the courts. You can name a single guardian or co-guardians (e.g. sister and brother-in-law).
Husband First Choice
Relationship to Husband
Husband 1st Alt. Executor
Relationship to Husband
Husband 2nd Alt. Executor
Relationship to Husband
Wife First Choice
Relationship to Wife
Wife 1st Alt. Executor
Relationship to Wife
Wife 2nd Alt. Executor
Relationship to Wife

Guardian: This person will make financial decisions for you in the event you are unable to do so for yourself.
Husband First Choice
Relationship to Husband
Husband 1st Alt. Executor
Relationship to Husband
Husband 2nd Alt. Executor
Relationship to Husband
Type of power of attorney?
- Durable
- Springing
Wife First Choice
Relationship to Wife
Wife 1st Alt. Executor
Relationship to Wife
Wife 2nd Alt. Executor
Relationship to Wife
Type of power of attorney?
- Durable
- Springing
Health Care Power of Attorney: This person will make medical decisions for you in the event you are unable to do so for yourself.
Husband First Choice
Relationship to Husband
Husband 1st Alt. Executor
Relationship to Husband
Husband 2nd Alt. Executor
Relationship to Husband
Type of power of attorney?
- Durable
- Springing
Wife First Choice
Relationship to Wife
Wife 1st Alt. Executor
Relationship to Wife
Wife 2nd Alt. Executor
Relationship to Wife
Type of power of attorney?
- Durable
- Springing
Trustee: If your estate plan will incorporate trust planning (e.g. revocable or irrevocable trust), the trustee will administer the trust.
Husband First Choice
Relationship to Husband
Husband 1st Alt. Executor
Relationship to Husband
Husband 2nd Alt. Executor
Relationship to Husband
Wife First Choice
Relationship to Wife
Wife 1st Alt. Executor
Relationship to Wife
Wife 2nd Alt. Executor
Relationship to Wife

Advisors
Please provide the name, company info, phone and email information for the followiong, if applicable.
Attorney:
Name
First Last
Company
Phone
Email
Accountant:
Name
First Last
Company
Phone
Email
Financial Planner
Name
First Last
Company
Phone
Email
Life Insurance Agent
Name
First Last
Company
Phone
Email
Personal Banking
Name
First Last
Company
Phone
Email
Business Banking
Name
First Last
Company
Phone
Email
Other
Name
First Last
Company
Phone
Email
Asset Summary
The purpose of this section is to determine an approximate value of the estate, which will help identify needs and options for the intended estate plan. For each asset category, please provide an estimated value or approximate balance for assets held by you and your spouse, as well the total debt against such assets. This will include assets held individually by either spouse and assets held jointly. Depending on the results of this summary, additional and more detailed information may be required to properly determine appropriate estate planning needs and structure.
Real Estate
Estimated Value/Approximate Balance
Loan/Debt Balance
Cash Accounts
Estimated Value/Approximate Balance
Loan/Debt Balance
Investment Accounts/Mutual Funds
Estimated Value/Approximate Balance
Loan/Debt Balance
Stocks and Bonds
Estimated Value/Approximate Balance
Loan/Debt Balance
Automobiles (e.g. cars and boats)
Estimated Value/Approximate Balance
Loan/Debt Balance
General Household Items
Estimated Value/Approximate Balance
Loan/Debt Balance
Special Household Items (e.g. art)
Estimated Value/Approximate Balance
Loan/Debt Balance
IRA's, 401(k) plans, annuities, etc.
Estimated Value/Approximate Balance
Loan/Debt Balance
Life Insurance
Estimated Value/Approximate Balance
Loan/Debt Balance
Notes and Other Receivables
Estimated Value/Approximate Balance
Loan/Debt Balance
Partnership and Business Interests
Estimated Value/Approximate Balance
Loan/Debt Balance
Oil, Gas, Mineral and Water Interests
Estimated Value/Approximate Balance
Loan/Debt Balance
Anticipated Judgments (from suits)
Estimated Value/Approximate Balance
Loan/Debt Balance
Anticipated Judgments (from suits)
Estimated Value/Approximate Balance
Loan/Debt Balance
Other Assets
Estimated Value/Approximate Balance
Loan/Debt Balance
Additional Debts
Please identify the total (estimated) amount owed on any debts, excluding any included above and consumer debts that are paid off each month:
Total Amount Owed

Estate Questionnaire

Step 1 of 6

Husband Personal Information

Wife Personal Information

Children and Beneficiaries

Designated Persons

Additional Questions

Advisors

Asset Summary

Additional Debts