Probate Intake Form

PROBATE CASE CLIENT INTAKE FORM

If you don't have all this information right now, don't worry. You can save this form and return to complete it later. Very few questions are mandatory. You can also upload a copies of documents (like bank statements) instead of typing out details. The drop-and-drag link to upload documents is at the end of this form. We will need a certified death certificate, the legal services agreement and a deposit of $1,500 to start the process.
Name of Estate Proposed Representative (person acting on behalf of the deceased)

PrefixFirst NameMiddle NameLast NameSuffix
Estate Representative's Phone Number
Please enter a valid phone number.
Email for Communication on the Estate
example@example.com
Mailing Address for Legal Documents about the Estate:

Street Address

Street Address Line 2

CityState

Zip Code
Personal Representative's Relationship to Decedent:

Surviving SpouseAdult Child of Decedent (biological or adopted)Parent of DecedentSibling of DecedentOther
Full Legal Name of Deceased

First NameMiddle NameLast NameSuffix
Decedent's Date of Birth

MonthDayYear
Date of Death

MonthDayYear
Decedent's Social Security number (as listed on the death certificate)
Where did the Decedent live at the time of their death? (City & County, State)
Decedent's Mother's Name (listed on death certificate)

First NameMiddle NameLast Name
Decedent's Father's Name (listed on death certificate)

First NameMiddle NameLast NameSuffix
Did the Decedent own Real Property?

YesNo
CHILDREN - Did the Deceased have any children? Did they have any biological or step children?

YesNo
Did the Deceased have any children - biological children, stepchildren, adopted?

Yes, they had childrenNo, they did not have any children
How many children?

One ChildTwo ChildrenThree ChildrenFour ChildrenFive ChildrenOther
Did the Deceased have any living Siblings?

Yes, they had a living sister or brother (or both)No, they did not have a living sister or brother.
How many siblings?

One SiblingTwo SiblingsThree SiblingsFour SiblingsFive Siblings
Beneficiary Listing - Child of Decedent #1

First NameMiddle NameLast NameSuffix
Date of Birth - Child #1

MonthDayYear
Email - Child #1
example@example.com
Mailing Address - Child #1

Street Address

Street Address Line 2

CityState

Zip Code
Beneficiary Listing - Child #2

First NameMiddle NameLast NameSuffix
Date of Birth - Child #2

MonthDayYear
Phone Number - Child #2
Please enter a valid phone number.
Beneficiary Listing - Child of Decedent #3

First NameMiddle NameLast Name
Date of Birth - Child #3

MonthDayYear
Email - Child #3
example@example.com
Mailing Address - Child #3

Street Address

Street Address Line 2

CityState

Zip Code
Beneficiary Listing - #4 Child of Decedent

First NameMiddle NameLast Name
Date of Birth - Child #4

MonthDayYear
Phone Number - Child #4
Please enter a valid phone number.
Email - Child #4
example@example.com
Mailing Address - Child #4

Street Address

Street Address Line 2

CityState

Zip Code
Beneficiary Listing - Child of Decedent #5

First NameMiddle NameLast Name
Date of Birth - Child #5

MonthDayYear
Email - Child #5
example@example.com
Mailing Address - Child #5

Street Address

Street Address Line 2

CityState

Zip Code
ASSETS

There are Probate Assets and Non-Probate Assets. Among these, we break it down further into Real Estate, Cash Assets, and Non-Cash assets. Some assets may transfer outside of Probate. All non-cash assets over a certain amount, such as stocks and real property, must be appraised by a Probate Referee.
REAL ESTATE Owned by Decedent (List by address, city, and county) Identify any other owners of the property if known. A certified deed will be reviewed for ownership.
PERSONAL PROPERTY - Named in Will, Specific Gifts, or Notable Items This is all the property that is specifically mentioned - the Court will require receipts from beneficiaries at the end of the case. The receipt requirement includes personal property items from the estate. Please do not give or throw anything away without confirming first with other family members. Photographs / media should be copied.
CASH Assets at Financial Institutions List where the Account is, the account numbers, and estimated balance if known. If there is a named beneficiary on the account, it will generally be transferred to the known listed beneficiary. If there is no living adult beneficiary named, it is a probate asset. (I generally do not include cash found at the household of less than $1,000)
NON-CASH Assets - Property like Cars, Boats, RVs, Stocks, Art, Jewelry, Mineral Interests, Guns, Antiques, Retirement Accounts such as CalPERS, CalSTRS, and any specific assets or valuables mentioned in the Will or known to exist. If possible, please provide VIN numbers, descriptions, insurance appraisals, and all recent bank or retirement statements. This information can help us include all the assets in the estate.
Do you anticipate any argument, dispute, conflict or possible litigation over the distribution of the Decedent's estate? (Can discuss in person at appointment)

YesNoNot Sure
File Upload

Please attach any scanned files related to the decedent here, such as a death certificate, bank statements, deeds, etc. If you have an original copy of the Will, please bring the original documents to your appointment.
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Name of Person Completing Form - By my signature below, I confirm the truthfulness and completeness of the information provided. The above is complete and accurate information regarding all assets, all potential heirs or beneficiaries, all debts, all income, and all known biological relationships*

First NameMiddle NameLast Name
PAYMENT DUE INFORMATION - PROBATE DEPOSIT $1,500 - This amount is used to cover mailing, postage, copy costs and court filing fees. This is not the attorney fee. The attorney fee is paid at the end of the case, from the estate, based on a statutory formula.
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Probate DepositA deposit of $1,500 (fifteen hundred) is required. This amount is used for payment of publication notices, postage, court filing fees, and for certified copies of documents. Payment may be made by check, cash, credit card or money order. Credit card charges incur a fee of 3.5%. Bank transfers incur a fee of 1.0%. Payment may also be mailed to: LAW OFFICES OF KATHLEEN SIEMONT 701 SOUTHAMPTON RD., #211, BENICIA, CA 94510
$1,500 Quantity

Total

$0.00

Payment Methods

Debit or Credit Card

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PROBATE CASE CLIENT INTAKE FORM

ASSETS