Fill and Sign the Estate Planning Questionnairefree Legal Forms

ESTATE PLANNING QUESTIONNAIRE: 1 ESTATE PLANNING QUESTIONNAIRE DATE:__________________________ PERSONAL INFORMATION FULL NAME: __________________________________________________________________ SOCIAL SECURITY NUMBER:_______________________ BIRTHDATE: ___________ CITIZENSHIP: ______________ MARITAL STATUS:__________ HOME ADDRESS: _____________________________________________ _____________________________________________ COUNTY OF RESIDENCE:_____________________ HOME TELEPHONE: (______) __________ -______________ HOME FACSIMILE: (______) __________ -______________ OTHER CONTACT#: (______) __________ -______________ HOME E -MAIL: _________________________________ OCCUPATION: ________________________________________ EMPLOYER: _________________________________________ BUSINESS ADDRESS: _____________________________________________ _____________________________________________ BUS TELEPHONE: (______) __________ -______________ BUS FACSIMILE: (______) __________ -______________ OTHER CONTACT#: (______) __________ -______________ BUSINES S E -MAIL: _________________________________ Previously married?: ______________ If so, please provide: (a) Name of former spouse: __________________________________________ (b) Date on which terminated: __________________________________________ (c) M anner in which the marriage terminated:_________________________________ (d) Descendant(s) of prior marriage: ____________________________________ ____________________________________ (e) Was there a premarital or postmarital agreement'? ________________ ________ PLEASE PROVIDE A COPY OF ANY DIVORCE DECREE, PREMARITAL AGREEMENT OR POSTMARITAL AGREEMENT. ESTATE PLANNING QUESTIONNAIRE: 2 SPOUSE'S INFORMATION FULL NAME: __________________________________________________________________ SOCIAL SECURITY NUMBER:_______________________ BIRTHDAT E: ___________ CITIZENSHIP: ______________ MARITAL STATUS:__________ HOME ADDRESS: _____________________________________________ _____________________________________________ COUNTY OF RESIDENCE:_____________________ HOME TELEPHONE: (______) __________ -______________ HOME FACSIMILE: (______) __________ -______________ OTHER CONTACT#: (______) __________ -______________ HOME E -MAIL: _________________________________ OCCUPATION: ________________________________________ EMPLOYER: __ _______________________________________ BUSINESS ADDRESS: _____________________________________________ _____________________________________________ BUS TELEPHONE: (______) __________ -______________ BUS FACSIMILE: (______) __________ -______________ OT HER CONTACT#: (______) __________ -______________ BUSINESS E -MAIL: _________________________________ Previously married?: ______________ If so, please provide: (a) Name of former spouse: __________________________________________ (b) Date on which ter minated: __________________________________________ (e) Manner in which the marriage terminated:_________________________________ (f) Descendant(s) of prior marriage: ____________________________________ ____________________________________ (e) Was the re a premarital or postmarital agreement'? ________________________ PLEASE PROVIDE A COPY OF ANY DIVORCE DECREE, PREMARITAL AGREEMENT OR POSTMARITAL AGREEMENT. ESTATE PLANNING QUESTIONNAIRE: 3 FAMILY MEMBERS Please list living parents, children and grandchildren or yourself and your spouse. Please also list any other individuals who will be beneficiaries under your estate plans. and any other individuals whom you may consider naming as Executor, Trustee or Gu ardian. Please indicate whether their relation is to yourself or your spouse, and for Grandchildren please indicate which child is the parent. NAME RELATION ADDRESS BORN _______________ ____________ _______ _________________ __________ ________________________ _______________ ____________ ________________________ __________ ________________________ _______________ ____________ ________________________ __________ ________________________ ____ ___________ ____________ ________________________ __________ ________________________ _______________ ____________ ________________________ __________ ________________________ _______________ ____________ ________________________ __________ ________________________ ________________________ _______________ ____________ ________________________ __________ ________________________ _______________ ____________ ________________________ __________ ________________________ _____ __________ ____________ ________________________ __________ ________________________ ________________________ _______________ ____________ ________________________ __________ ________________________ _______________ ____________ ___ _____________________ __________ ________________________ _______________ ____________ ________________________ __________ ________________________ ________________________ _______________ ____________ ________________________ __________ ________________________ Please indicate if any child, grandchild or other potential beneficiary is: ___ adopted ___ born out of wedlock ___ divorced or separated ___ physically or mentally handicapped ESTATE PLANNING QUESTIONNAIRE: 4 FINANCIAL INFORNIATION ASSETS IN YOUR NAME IN SPOUSES NAME IN JOINT NAME TOTAL HOME VACATION HOME OTHER R.E. (LOCATION) CASH ACCOUNTS TAX EXEMPT MUNICIPAL BONDS OTHER MARKETABLE SECURITIES CLOSELY -HEL D BUSINESS INTERESTS PARTNERSHIP INVESTMENT INVESTMENT GEMS & METALS LIFE INSURANCE (DEATH BENEFIT) VESTED RETIREMENT BENEFITS INDIVIDUAL RETIREMENT ACCOUNTS VALUABLE COLLECTIONS AUTOS & OTHER PERSONAL PROPERTY ESTATE PLANNING QUESTIONNAIRE: 5 OTHER ASSETS (SPECIFY) TOTAL ASSETS LIABILITES OWED BY YOU OWED BY SPOUSE OWED JOINTLY TOTAL MORTGAGE ON HOME MORTGAGE ON VACATION HOME LOANS AND OTHER DEBTS TOTAL LIABILITIES NET WORTH FOR ESTATE PLANNING: ______________________________________ ASSET CLASSIFICATION Is home: ___ House ____ Condominium ____ Co -op Is title in land trust? ___ Yes ____ No Is vacation home: ___ House ____ Condominium ____ Co -op Is title in land trust? ___ Yes ____ No Is any real estate potentially subject to any environmental concerns of which you are aware? _________________________________________________________________________ Total death benefits listed on item 2 above, excluding accidental death benefits. _________________________________________________________________________ Please describe any loans between family members. Assets, including death benefit from life insurance policies, minus liabilities. ___________________________________________________________________________ ESTATE PLANNING QUESTIONNAIRE: 6 1. Community Property Have you ever live d in a community property state during -, your marriage (Arizona, California, Idaho, Louisiana. Nevada, New Mexico, Texas, Washington or Wisconsin)? If so please indicate which one(s) and the dates on which you lived there: _______________________________ _______________________________________________ ______________________________________________________________________________ PLEASE IDENTIFY COMMUNITY PROPERTY SHOWN ABOVE BY PLACING A "C" TO THE RIGHT OF THE APPROPRIATE ENTRY. 2. Life Insurance Policie s COMPANY & POLICY NUMBER TYPE (GROUP, WHOLE LIFE, etc.) DEATH BENEFIT CASH VALUE LOAN S INSURED OWNE R BENEFI - CIARY 3. Joint Property If any of the property shown above is owned jointly with someone other than y our spouse, please indicate the co -owner(s), their respective interests in the property, and who provided the funds to purchase the property. If any of the liabilities shown above are joint liabilities with someone other than your spouse, please indicate the co -obligor(s) and the nature of their respective liabilities. ______________________________________________________________________________ ______________________________________________________________________________ ________________________________ ______________________________________________ 4. Business Interests List and briefly describe closely -held business interests. Please Indicate the type of' entity and your interest in the entity. ________________________________________________________ ______________________ ______________________________________________________________________________ ______________________________________________________________________________ PLEASE PROVIDE COPIES OF ANY PARTNERSHIP AGREEMENT, SHAREHOLDERS' AGREEMENT , BUY -SELL AGREEMENT, VOTING TRUST, OR OTHER SIMILAR AGREEMENT. 5. Employee Benefits ESTATE PLANNING QUESTIONNAIRE: 7 Describe any pension or profit -sharing plans applicable to yourself or your spouse. Give the name of the plan; general description of the benefits; the name of the bene ficiary; and indicate whether you made any contributions to the plan. ______________________________________________________________________________ ______________________________________________________________________________ Describe any stock options, deferred compensation and other employee benefits. ______________________________________________________________________________ ______________________________________________________________________________ PLEASE PROVIDE THE SUMMARY PLAN DESCRIPTION AND LATEST STATEMENT OF BENEFITS PROVIDED BY YOUR RESPECTIVE EMPLOYERS. 6. Individual Retirement Accounts OWNER TRUSTEE OR CUSTODIAN VALUE BENEFICIARY 7. Tangible Personal Property Please describe any tangible personal property requiring special treatment (for example, art objects, collections, boats, horses or antiques). ______________________________________________________________________________ ___________________________________ ___________________________________________ 8. Trusts Please describe any trust you or vour spouse has established, including, the value of the trust assets. Did the trust become irrevocable on or before September 25, 1985? If so, were additional contr ibutions made to it after September 25, 1985? ______________________________________________________________________________ ______________________________________________________________________________ Please describe any interest that you or any family members have in any trust created by another, including the value of the trust assets. Did the trust become irrevocable on or before September 25, 1985? If so, were additional contributions made to it after September 25, 1985? ____________________________ __________________________________________________ ______________________________________________________________________________ PLEASE PROVIDE COPIES OF ANY SUCH TRUST INSTRUMENTS. 9. Children's Assets ESTATE PLANNING QUESTIONNAIRE: 8 Please describe any property held for your children, such as under a Uniform Transfers to Minors Act. ______________________________________________________________________________ ____________________________________________________________________________ __ 10. Inheritances Please describe any property you or your spouse has inherited within the past 10 years. ______________________________________________________________________________ ________________________________________________________________ ______________ Please describe any inheritance that you or any member of your family expects to receive in the future. ______________________________________________________________________________ __________________________________________________________ ____________________ ADDITIONAL INFORMATION 1. Gifts Have you ever filed a gift tax return? ____ Yes _____ No Has your spouse ever filed a gift tax return? ____ Yes _____ No Please describe any gifts you or your spouse has made to any person (other than to each other and other than any gifts fully disclosed on a gift -tax return). ______________________________________________________________________________ PLEASE PROVIDE A COPY OF ALL GIFT TAX RETURNS YOU OR YOUR SPOUSE HAS FILED. 2. Current Estate Plan ning Documents ______________________________________________________________________________ PLEASE PROVIDE COPIES OF YOUR CURRENT ESTATE PLANNING DOCUMENTS. 3. Family Advisors NAME ADDRESS CONTACT #s YOUR PHYSICIAN SPOUSE'S PHYSICIAN ACCOUNTANT TAX PREPARER INVESTMENT ADVISOR INSURANCE TRUST OFFICER OR BANKER 4. Safe deposit box ESTATE PLANNING QUESTIONNAIRE: 9 Where is your safe deposit box and who has access to it? ______________________________________________________________________________ ______________________________________________________________________________