• ESTATE PLANNING INTAKE

    ESTATE PLANNING INTAKE

    WORKSHEET FOR UNMARRIED COUPLE

  • Please complete this worksheet at your earliest convenience. Estimated values for assets and liabilities are fine. If you run out of space for any question, please include that information in the “Additional Information” section at the end of the worksheet.

  • BIOGRAPHICAL INFORMATION

  • 1st PARTNER

  • Birth Date:*
     / /
  • US Citizen*
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Is Partner 1 Employed?*
  • Format: (000) 000-0000.

  • 2nd PARTNER

  • Birthdate:*
     / /
  • US Citizen*
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Is Partner 2 Employed?*
  • Format: (000) 000-0000.

  • CHILDREN

  • Do you now or have you ever had children?*

  • 1st CHILD

  • Birthdate:*
     / /
  • US Citizen?*
  • Are both partners the biological or adoptive parents of the child?*
  • Format: (000) 000-0000.
  • If child is deceased, date of death:
     / /
  • Another child?*

  • 2nd CHILD

  • Birthdate:*
     / /
  • US Citizen?*
  • Are both partners the biological or adoptive parents of the child?*
  • Format: (000) 000-0000.
  • If child is deceased, date of death:
     / /
  • Another child?*

  • 3rd CHILD

  • Birthdate:*
     / /
  • US Citizen?*
  • Are both partners the biological or adoptive parents of the child?*
  • Format: (000) 000-0000.
  • If child is deceased, date of death:
     / /

  • OTHER IMPORTANT FRIENDS OR FAMILY MEMBERS

  • Are there any important friends or family members that you may include in your estate plan (for example, as a beneficiary or executor of your estate)?*

  • 1st PERSON

  • Birthdate:*
     / /
  • US Citizen?*
  • Format: (000) 000-0000.
  • Another Person?*

  • 2nd PERSON

  • Birthdate:*
     / /
  • US Citizen?*
  • Format: (000) 000-0000.

  • PETS

  • Do you have pets?*
  • Another pet?*

  • PROFESSIONAL ADVISORS

  • Do you have a CPA or accountant?*
  • Format: (000) 000-0000.
  • Do you have a financial or wealth management advisor?*
  • Format: (000) 000-0000.
  • Do you have a life insurance agent?*
  • Format: (000) 000-0000.
  • Do you have any other attorneys (business, tax, etc)?*
  • Format: (000) 000-0000.

  • IMPORTANT QUESTIONS

  • Have either of you completed previous will, trust or estate planning? If Yes, please email copies.*
  • Are either of you receiving Social Security, disability, or other governmental benefits?*
  • Are either of you making payments pursuant to a divorce or property settlement order? If Yes, please email a copy of the order.*
  • Have you entered into a cohabitation agreement? If Yes, please email copy of the agreement.*
  • Have either of you ever been widowed? If a federal estate tax return or a state death tax return was filed, please email us a copy of the return(s).*
  • Have either of you ever filed a federal or state gift tax return? If Yes, please email copies of the return(s).*
  • Have you chosen any charitable organizations that you wish to make provisions for at the time of your death?*
  • To your knowledge, are either of you the current or remainder beneficiary of anyone else’s revocable or irrevocable trust (parents, grandparents)?*
  • Do any of your children have special educational, medical or physical needs?*
  • Do any of your children receive governmental support or benefits?*
  • Do you provide primary or other major financial support to adult children or others?*
  • Are there any specific goals or concerns that you would like to address in your estate plan?*

  • PROPERTY INFORMATION

  • REAL ESTATE

  • Do you own any real estate (personal residence, vacation home, vacant land, timeshare)?*

  • 1st PROPERTY

  • Another property?*

  • 2nd PROPERTY

  • Another property?*

  • 3rd PROPERTY

  • PERSONAL PROPERTY

  • Other than ordinary household furnishings and personal effects, do you own any personal property of significant financial value (jewelry, artwork, collectibles, etc)?*
  • Insured?*
  • Additional Personal Property?*
  • Insured?*

  • VEHICLES

  • Do you own any automobiles, boats, recreational vehicles (RV) or other vehicles?*

  • 1st VEHICLE

  • Insured?*
  • Another Vehicle?*

  • 2nd VEHICLE

  • Insured?*

  • DEPOSIT ACCOUNTS

  • Do you own any deposit accounts (checking, savings, money market, CDs)?*

  • 1st ACCOUNT

  • Have you named a transfer-on-death beneficiary?*
  • Another Account?*

  • 2nd Account

  • Have you named a transfer-on-death beneficiary?*
  • Another Account?*

  • 3rd Account

  • Have you named a transfer-on-death beneficiary?*

  • RETIREMENT PLAN ACCOUNTS

  • Do you own any retirement plans (401(k), 403(b), Traditional or Roth IRAs, etc)?*

  • 1st ACCOUNT

  • Have you named a beneficiary?*
  • Another Account?*

  • 2nd ACCOUNT

  • Have you named a beneficiary?*
  • Another Account?*

  • 3rd ACCOUNT

  • Have you named a beneficiary?*

  • TAXABLE INVESTMENT ACCOUNTS

  • Do you own any taxable investment accounts?*

  • 1st ACCOUNT

  • Have you named a transfer-on-death beneficiary?*
  • Another Account?*

  • 2nd ACCOUNT

  • Have you named a transfer-on-death beneficiary?*
  • Another Account?*

  • 3rd ACCOUNT

  • Have you named a transfer-on-death beneficiary?*

  • LIFE INSURANCE AND ANNUITIES

  • Are you the owner, insured or beneficiary of any life insurance policies or annuities?*

  • 1st POLICY

  • Another Policy?*

  • 2nd POLICY

  • BUSINESS INTERESTS

  • Do you own any closely held business interests?*

  • 1st BUSINESS

  • Have you entered into any Shareholder Agreements, Operating Agreements or Buy-Sell Agreements?*
  • Another business?*

  • 2nd BUSINESS

  • Have you entered into any Shareholder Agreements, Operating Agreements or Buy-Sell Agreements?*

  • DEBTORS

  • Does anyone owe any money to you?*

  • 1st DEBTOR

  • Original Date of Loan:*
     / /
  • Maturity Date:*
     / /
  • Secured?*
  • Did you document the loan with a written Promissory Note?*
  • Another Debtor?*

  • 2nd DEBTOR

  • Original Date of Loan:*
     / /
  • Maturity Date:*
     / /
  • Secured?*
  • Did you document the loan with a written Promissory Note?*

  • GIFTS, INHERITANCES AND OTHER ASSETS

  • Do you anticipate receiving any gifts or inheritances from a third party (parents, grandparents, trust distributions) at some time in the future?*
  • Do you have any other significant assets that do not fit into any of the above categories (whether significant for financial or sentimental reasons)?*

  • OTHER DEBT

  • Other than mortgages and loans already referenced above, do you have any outstanding debt?*

  • 1st LENDER

  • Original Date of Loan:*
     / /
  • Maturity Date:*
     / /
  • Secured?*
  • Another Debt?*

  • 2nd LENDER

  • Original Date of Loan:*
     / /
  • Maturity Date:*
     / /
  • Secured?*

  • ADDITIONAL INFORMATION

  •  
  • Should be Empty: