Did anyone refer you to us?

Yes
No

If yes, whom may we thank?

General Information

Client Full Legal Name*

Preferred Name

Citizen of US?*

Yes
No

If not a citizen of the US, what country are you a citizen of?

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Date of birth*

MM

DD

YYYY

Cell Phone*

Email*

Relationship To Decedent

Best method of contact:

Decedent Information

Decedent Full Legal Name*

Was Decedent a Citizen of US?*

Yes
No

If not a citizen of the US, what country were they a citizen of?

Decedent Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Date of Birth

Date of Death

Location of Will (If applicable)

Date of Will

Personal Representative Information

The person or entity who will manage the legal affairs.

Name of Personal Representative

Relation

Phone

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Personal Representative (1)

Relation

Phone

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Personal Representative (2)

Relation

Phone

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Personal Representative (3)

Relation

Phone

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Children's Guardian Designation (For children under age 18 who are a direct beneficiary of the estate) - (Two persons may serve as long as they are married)

1st Guardian(s)

Relation

Phone

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

2nd Guardian(s)

Relation

Phone

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Durable Power of Attorney Designation?

A durable power of attorney gives the person(s) named the power to sign another's name if they are not able to do so. For instance, it can be used to sign a deed or tax return, or to make gifts of your property.

1st Power of Attorney

Relation

Phone

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

2nd Power of Attorney

Relation

Phone

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Other beneficiaries

Other individuals or groups of individuals who would have an interest in the estate.

Please list who else could have an interest in the estate.

Assets

All property titled in the decedent's sole name without co-owners or payable-on-death and beneficiary designations. They commonly include bank accounts, investment accounts, stocks, bonds, vehicles, boats, airplanes, business interests, and real estate.

Is there a safety deposit box?

Yes
No

Real Estate

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Stocks & Bonds

Name of Company

Type of Security

How Titled

Location of Certificate

Date of Death Value

Name of Company

Type of Security

How Titled

Location of Certificate

Date of Death Value

Name of Company

Type of Security

How Titled

Location of Certificate

Date of Death Value

Name of Company

Type of Security

How Titled

Location of Certificate

Date of Death Value

Bank Accounts

Bank Name

Account Number

How Titled

Date of Death Value

Bank Name

Account Number

How Titled

Date of Death Value

Bank Name

Account Number

How Titled

Date of Death Value

Bank Name

Account Number

How Titled

Date of Death Value

Bank Name

Account Number

How Titled

Date of Death Value

Money Market Accounts Or Certificates of Deposit

Name Of Institution

Account Number

How Titled

Date of Death Value

Name Of Institution

Account Number

How Titled

Date of Death Value

Name Of Institution

Account Number

How Titled

Date of Death Value

Name Of Institution

Account Number

How Titled

Date of Death Value

Name Of Institution

Account Number

How Titled

Date of Death Value

U.S. Government Savings Bonds (E,EE, H)

How Titled

Location of Bonds

To Be Cashed

Insurance on Decendent's Life

Company Name

Policy Number

Beneficiaries Named

Location of Policy

Date of Death Value

Company Name

Policy Number

Beneficiaries Named

Location of Policy

Date of Death Value

Company Name

Policy Number

Beneficiaries Named

Location of Policy

Date of Death Value

Annuities

Company Name

Policy Number

Beneficiaries Named

Location of Policy

Date of Death Value

Company Name

Policy Number

Beneficiaries Named

Location of Policy

Date of Death Value

Company Name

Policy Number

Beneficiaries Named

Location of Policy

Date of Death Value

Vehicles

Please provide a list of the types involved in the estate.

Miscellaneous

Personal Property

Documents Needed By This Office

If you can please provide our office with Death Certificates, Paid Funeral Bill, Real Estate Deeds, Copies of Any Bills/ Creditors Addresses, & a Last Will & Testament.

Upload Your Documents

Drop files here or

Estate Planning

Asset Protection

Business Law

Probate

Elder Law

Guardianship Law

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Practice Areas

Probate Intake Questionnaire

General Information

Decedent Information

Personal Representative Information

Children's Guardian Designation (For children under age 18 who are a direct beneficiary of the estate) - (Two persons may serve as long as they are married)

Durable Power of Attorney Designation?

Other beneficiaries

Assets

Real Estate

Stocks & Bonds

Bank Accounts

Money Market Accounts Or Certificates of Deposit

U.S. Government Savings Bonds (E,EE, H)

Insurance on Decendent's Life

Annuities

Vehicles

Miscellaneous

Documents Needed By This Office

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