Probate Intake Sheet

Probate/Administration Intake Sheet
Date of Appointment:*

MonthDayYear
Instructions: Complete all sections to the best of your ability. Mr. Luquire will review all information with you during your consultation.
PERSONAL INFORMATION - CLIENT
Full Legal Name:*

First NameMiddle NameLast NameSuffix
Address:*

House No., Street Name, Apt. No.

County

CityState

Zip Code
Home Phone:
Work Phone:
Cell Phone:
Email:
Date of Birth:*

MonthDayYear
Social Security Number: (optional)
Your Relationship to Decedent:*

SpouseChildPersonal RepresentativeNone

PERSONAL INFORMATION - DECEDENT
Full Legal Name:*

First NameMiddle NameLast NameSuffix
Date of Death:*

MonthDayYear
Date of Birth:*

MonthDayYear
Social Security Number: (optional)
Address at time of Death:*

House No., Street Name, Apt. No.

County

CityState

Zip Code
Marital Status at time of Death:*

SingleMarriedSeparatedDivorcedWidowed
Did Decedent have a Will:*

YesNo

PROPOSED PERSONAL REPRESENTATIVE

(If other than Client)
Are you the proposed Personal Representative?*

YesNo - Please provide the following information about the proposed Personal Representative:

Full Legal Name:*

First NameMiddle NameLast NameSuffix
Full Address:*

House No., Street Name, Apt. No.

County

CityState

Zip Code
Home Phone:
Work Phone:
Cell Phone:
Email:
Date of Birth:*

MonthDayYear
Social Security Number: (optional)

DECEDENT'S SPOUSE

(If other than Client)
Are you the Decedent's Spouse?*

YesNo - Please provide the following information about the Decedent's Spouse:

Full Legal Name:*

First NameMiddle NameLast NameSuffix
Full Address:*

House No., Street Name, Apt. No.

County

CityState

Zip Code
Is the Decedent's Spouse deceased?*

NoYes- Please provide the following:

DECEDENT'S PROPERTY INFORMATION
1. Real Property
Did Decedent own Real Property such as a family residence, vacation home, time-share, vacant land, etc.?*

NoYes - Please provide the following information:

2. Furniture and Personal Effects
Did Decedent own Furniture or Personal Effects?*

NoYes - Please provide the following information:

3. Automobiles, Boats and RVs
Did Decedent own Automobiles, Boats or RVs?*

NoYes - Please provide the following information:

3. Bank and Savings Accounts
Did Decedent have any Bank or Savings Accounts?*

NoYes - Please provide the following information:

4. Stocks and Bonds
Did Decedent have any Stocks and Bonds?*

NoYes - Please provide the following information:

5. Life Insurance Policies and Annuities
Did Decedent have any Life Insurance Policies or Annuities?*

NoYes - Please provide the following information:

6. Retirement Plans
Did Decedent have any Retirement Plans?*

NoYes - Please provide the following information:

7. Other Assets

Not already listed.
Did Decedent have any Other Assets not already listed?*

NoYes - Please provide the following information:

Additional Relevant Information & Explanation

You have completed the worksheet.

You may review the worksheet prior to submission by clicking the "Preview PDF" button.

After you are finished reviewing, please click the "Submit" button to email to our office for printing prior to your appointment.
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Probate/Administration Intake Sheet

PERSONAL INFORMATION - CLIENT

PERSONAL INFORMATION - DECEDENT

PROPOSED PERSONAL REPRESENTATIVE

DECEDENT'S SPOUSE

DECEDENT'S CHILDREN

Child 1

Child 2

Child 3

Child 4

OTHER BENEFICIARIES NAMED IN THE WILL

OTHER BENEFICIARIES NAMED IN THE WILL

Other Beneficiary 1

Other Beneficiary 2

DECEDENT'S PROPERTY INFORMATION

1. Real Property

Real Property 1

Real Property 2

Real Property 3

Real Property 4

2. Furniture and Personal Effects

Furniture and Personal Effect 1

Furniture and Personal Effect 2

Furniture and Personal Effect 3

Furniture and Personal Effect 4

3. Automobiles, Boats and RVs

Automobiles, Boats and RVs 1

Automobiles, Boats and RVs 2

Automobiles, Boats and RVs 3

3. Bank and Savings Accounts

Bank Account 1

Bank Account 2

Bank Account 3

4. Stocks and Bonds

Stock or Bond 1

Stock or Bond 2

Stock or Bond 3

5. Life Insurance Policies and Annuities

Life Insurance Policy or Annuity 1

Life Insurance Policy or Annuity 2

6. Retirement Plans

Retirement Plan 1

Retirement Plan 2

7. Other Assets

Other Asset 1

Other Asset 2

Other Asset 3

DECEDENT'S DEBTS OR KNOWN CREDITORS

Debt 1

Debt 2

Debt 3

Debt 4

Debt 5

Debt 6

Debt 7