Estate Planning Questionnaire

Please fill out the form below. Once we've received it, we'll review your information and contact you to discuss your estate plan, no obligations and free of charge. Required fields are marked with an asterisk (*).

Personal Information

Name

First Name

Last Name

Preferred Contact Method

Do you prefer to be contacted by:

Email.

Phone call.

Letter.

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Email Address

Phone

(###)

###

####

Family Members

Please enter the following information regarding your family, including stepchildren, adoptive children, and children who have passed away.

Marital Status

Spouse

Please enter your current or most recent spouse's name.

First Name

Last Name

Child 1

First Name

Last Name

Child 2

First Name

Last Name

Child 3

First Name

Last Name

Child 4

First Name

Last Name

Other Information

Please use this space for any further information you'd like to give about your family.

Property

Real Estate

Please list any real estate in which you own an interest.

Businesses

Please list and describe any businesses in which you hold an interest.

Disposition of Property

Real Estate

Please describe whom you want to receive your real estate holdings when you pass away.

Personal Property

If there are any items of personal property (autos, furniture, jewelry, bank accounts, etc.) which you would like to leave to a specific person, please list such items and the person selected.

All Other Property

Any property not disposed of in the previous two sections falls into what is called the "residuary." To whom would you like to leave the residue of your estate?

Other

Please list any other instructions or wishes you'd like us to know about.