Estate Planning Questionnaire

ESTATE PLANNING QUESTIONNAIRE While most lawyers and law firms use a specific estate planning intake form, this form is very comprehensive and will allow you to gather the necessary information for estate planning. <<<<<<<<<********>>>>>>>>>>>>> 2 GENERAL INFORMATION YOURSELF SPOUSE1. Name: _____________________ _____________________2. Other name or nickname known by, if any: _____________________ _____________________3. Home address: _____________________ _____________________ _____________________ _____________________ _____________________ _____________________4. Home telephone number: _____________________ _____________________5. Social Security number: ______________________ ______________________6. Occupation: ______________________ _______________________7. Business address: ______________________ _______________________8. Business telephone number: ______________________ ______________________ 2 <<<<<<<<<********>>>>>>>>>>>>> 3 YOURSELF SPOUSE9. Date of birth: ______________________ ______________________10. Citizen of U.S.? Yes No Yes No11. Length of residence in this state: ______________________ ______________________12. Other states or countries previously resided in, and dates of residence: ______________________ ______________________13. Have you entered into any pre-or post-nuptial agreements? (if so, attachcopy): Yes No Yes No14. Any prior marriages (if divorced, attach copies of divorce decree andproperty settlement agreement; if widowed, attach copy of Form 706 (federalstate tax return) for predeceased spouses estate): 3 <<<<<<<<<********>>>>>>>>>>>>> 4 FAMILY INFORMATION CHILDREN NAME, CHILD 1: _______________________________BIRTHDAY: _______________________________SOCIAL SECURITY NO: _______________________________ADDRESS: _______________________________ _______________________________NAME OF SPOUSE: _______________________________SPECIAL NEEDS: _______________________________NAME, CHILD 2: _______________________________BIRTHDAY: _______________________________SOCIAL SECURITY NO: _______________________________ADDRESS: _______________________________ _______________________________NAME OF SPOUSE: _______________________________SPECIAL NEEDS: _______________________________ 4<<<<<<<<<********>>>>>>>>>>>>> 5 CHILDREN NAME, CHILD 3: _______________________________BIRTHDAY: _______________________________SOCIAL SECURITY NO: _______________________________ADDRESS: _______________________________ _______________________________NAME OF SPOUSE: _______________________________SPECIAL NEEDS: _______________________________NAME, CHILD 4: _______________________________BIRTHDAY: _______________________________SOCIAL SECURITY NO: _______________________________ADDRESS: _______________________________ _______________________________NAME OF SPOUSE: _______________________________SPECIAL NEEDS: _______________________________ 5<<<<<<<<<********>>>>>>>>>>>>> 6 GRANDCHILDREN NAME: _______________________________BIRTHDAY: _______________________________PARENTS NAME: _______________________________NAME: _______________________________BIRTHDAY: _______________________________PARENTS NAME: _______________________________NAME: _______________________________BIRTHDAY: _______________________________PARENTS NAME: _______________________________NAME: _______________________________BIRTHDAY: _______________________________PARENTS NAME: _______________________________NAME: _______________________________BIRTHDAY: _______________________________PARENTS NAME: _______________________________ 6<<<<<<<<<********>>>>>>>>>>>>> 7 PARENTS YOURSELF FATHERS NAME: _______________________________BIRTHDAY: _______________________________MOTHERS NAME: _______________________________BIRTHDAY: _______________________________ SPOUSE FATHERS NAME: _______________________________BIRTHDAY: _______________________________MOTHERS NAME: _______________________________BIRTHDAY: _______________________________ 7<<<<<<<<<********>>>>>>>>>>>>> 8ADVISORS: (Please list name and telephone nos.)1. OTHER LAWYERS: ______________________________ _________________________2. ACCOUNTANT: ______________________________ _________________________3. STOCKBROKER: ______________________________ _________________________4. INVESTMENT ADVISOR: ______________________________ _________________________5. INSURANCE AGENT: ______________________________ _________________________6. OTHER (IDENTIFY): ______________________________ _________________________ 8 <<<<<<<<<********>>>>>>>>>>>>> 9PERSONAL ASSETS 1. :ING ACCOUNTKCECH NAME OF INSTITUTION: ______________________________ ADDRESS OF INSTITUTION: ______________________________ ______________________________ FULL NAME ON ACCOUNT: ______________________________ ACCOUNT NUMBER: ______________________________2. :TOUNACCS INGSAV NAME OF INSTITUTION: ______________________________ ADDRESS OF INSTITUTION: ______________________________ ______________________________ FULL NAME ON ACCOUNT: ______________________________ ACCOUNT NUMBER: ______________________________ 9 <<<<<<<<<********>>>>>>>>>>>>> 103. CES TEAICIFRT :ITOSDEPOF NAME OF INSTITUTION: ______________________________ ADDRESS OF INSTITUTION: ______________________________ ______________________________ FULL NAME ON ACCOUNT: ______________________________ ACCOUNT NUMBER: ______________________________4. MONEYMA- CC ATRKEOUNT: NAME OF INSTITUTION: ______________________________ ADDRESS OF INSTITUTION: ______________________________ ______________________________ FULL NAME ON ACCOUNT: ______________________________ ACCOUNT NUMBER: ______________________________5. STOCKS (INDICATE NAMES OF THE STOCK AND NUMBEROF SHARES): NAME OF INSTITUTION: ______________________________ ADDRESS OF INSTITUTION: ______________________________ ______________________________ FULL N AME ON ACCOUNT: ______________________________ ACCOUNT NUMBER: ______________________________ 10 <<<<<<<<<********>>>>>>>>>>>>> 116. BONDS (INCLUDING E, EE): NAME OF INSTITUTION: ______________________________ ADDRESS OF INSTITUTION: ______________________________ ______________________________ FULL NAME ON ACCOUNT: ______________________________ ACCOUNT NUMBER: ______________________________7. MUTUAL FUNDS: NAME OF INSTITUTION: ______________________________ ADDRESS OF INSTITUTION: ______________________________ ______________________________ FULL NAME ON ACCOUNT: ______________________________ ACCOUNT NUMBER: ______________________________8. :ACCOUNT BROKERAGE NAME OF IN