Clone of Estate Planning Worksheet for Single Individuals

ESTATE PLANNING WORKSHEET FOR SINGLE INDIVIDUAL

Information provided is held in complete confidence, and is used for the sole purpose of analyzing estate planning needs and designing estate planning documents. Preparation of this worksheet is not mandatory prior to the initial appointment with us, but if we are able to review the completed worksheet prior to your appointment, more information and value will be received during the complimentary initial consultation.

WE OFFER A FREE NO-OBLIGATION CONSULTATION

During your complimentary phone consultation, we will determine your specific estate planning needs and goals. The potential cost of probate and tax which would occur with your current plan will be analyzed, and methods of reducing costs and accomplishing goals will be discussed. Shortly after your consultation, in most cases an exact quote on fees for estate planning can be provided.

Attorney Colleen Cowles, Cowles Law Office

(715) 828-0293 Colleen@ccowleslaw.com

If married or in a same gender relationship, use that worksheet available at www.ccowleslaw.com.

Your Name*

First NameMiddle NameLast Name

AKA

Date of Birth*

Email

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

County

Occupation*

Phone Number*

What is your primary motivation for considering estate planning? (Select one or more)*

How soon would you like to complete planning? Is there a specific deadline, such as an upcoming trip, surgery, etc.?*

Do you presently have a will?*

YesNo

Do you presently have a trust?*

YesNo

Are you interested in avoiding probate on your estate?*

YesNo

Were there any previous marriages?*

YesNo

If yes, year marriage ended:

Do you own a farm or business?*

YesNo

If yes, do any of your children work in the business with you?*

YesNo

If yes, does the child working in the business have an ownership interest in the business?

YesNo

Are you a US citizen?*

YesNo

Do you or any family member or potential beneficiaries have any serious health problems?*

YesNo

If yes, please describe briefly.

Do you own a long-term care (nursing home) insurance policy?*

YesNo

INCOME/ASSET/LIABILITY INFORMATION

This information is for the purpose of tax planning and to assess most appropriate estate planning techniques for you. This information helps us in preparation for the appointment and is held in confidence.

Net Worth: If you added the value of all of your property including real estate, personal property, bank accounts, stocks, bonds, IRAs, and anything else you own except death benefits on life insurance, what is the approximate total value of your estate?*

What is the value of death benefits on life insurance?*

Types of Assets Owned*

Real EstateIRAs / 401KsStocks/Bonds/Other SecuritiesBusiness -Sole Proprietorship, Partnership, LLC

Real Estate - Number of Parcels

Other Assets

What is the total amount of your outstanding liabilities?*

1. NAME - As it should appear on documents

RELATIONSHIP

ADDRESS

DATE OF BIRTH

2. NAME - As it should appear on documents

RELATIONSHIP

ADDRESS

DATE OF BIRTH

3. NAME - As it should appear on documents

RELATIONSHIP

ADDRESS

DATE OF BIRTH

4. NAME - As it should appear on documents

RELATIONSHIP

ADDRESS

DATE OF BIRTH

5. NAME - As it should appear on documents

RELATIONSHIP

ADDRESS

DATE OF BIRTH

6. NAME - As it should appear on documents

RELATIONSHIP

ADDRESS

DATE OF BIRTH

APPOINTMENTS

1. Personal Representative. (The person who coordinates administration of the estate, also sometimes referred to as executor or administrator.)

Personal Representative*

Alternate

Second Alternate

2. Successor Trustee. If you choose to avoid probate of your estate by executing a living trust during lifetime, a successor trustee should be named. The successor trustee would be responsible for managing assets if you were unable due to incompetence and would distribute assets to beneficiaries after death. The successor trustee is often the same as the personal representative.

Successor Trustee*

Alternate

Second Alternate

3. Health Care Agent. Who should be named to make medical decisions on your behalf including decisions regarding medical consents, life support issues, and nursing home admission if you were unable to make these decisions yourself? The health care agent may be different than the personal representative and the successor trustee since authority to make medical decisions doesn't overlap with financial decisions.

Health Care Agent*

Alternate

Second Alternate

1. Specific Gifts. Do you want to make gifts to a charity? Do you wish to make a specific gift to a particular person, such as a piece of jewelry to a particular child?

2. Briefly describe the plan of distribution for assets remaining after any specific gifts described above are made. (Don’t worry about tax planning or other considerations in answering this question. We’ll consider those details later if needed.)*

Equally between children, and if a child does not survive, the deceased child's children would take the share of the deceased child.Equally among surviving children.As follows:

As follows: Insert desired plan of distribution.

3. Ultimate Distribution. If you would like to provide for the distribution of assets if neither you, nor your children/other beneficiaries named above survive, insert plan of distribution here.

Notes and Questions: Please note anything else which may be of importance in planning your estate, or note any questions you may have.

Complete this section if you have young beneficiaries, beneficiaries with disabilities, or if grandchildren or other young beneficiaries would inherit if a primary beneficiary didn't survive. These questions provide information to establish trusts to manage assets until beneficiaries reach designated ages. If management of assets would never be needed, this information is not required and your worksheet is now complete. Scroll down and hit the SUBMIT button.

1. Guardian. If you have child(ren) or other beneficiary(ies) who are minors or who have special needs, you may need to appoint a guardian. The guardian is responsible for the day-to-day care of the child. It is a good idea to name an alternate guardian to act if your first choice cannot serve.

Guardian

Alternate

2. Testamentary Trustee. You may need a trustee to manage assets for beneficiaries until they reach an age when you believe they should be capable of managing assets on their own. A trustee can keep the beneficiary’s money invested wisely and use it for their education, support, etc., until they reach the age specified for outright distribution of assets to them. The trustee can be a relative, friend, trust company, or other person or institution you trust to manage and distribute assets according to your wishes. The testamentary trustee can be the same person named as the guardian, or could be a different person or institution.

Testamentary Trustee

Alternate

3. Age of Distribution. If you do establish a trust to allow a third party to manage assets for beneficiaries, then it is necessary for you to decide when the beneficiaries will be mature enough to manage assets on their own. You may want to give each beneficiary his or her share at the time the beneficiary reaches a particular age. You may consider splitting the distribution, such as ½ at age 25 and the balance at age 30, or 1/3 at 21, 1/3 at 25, and 1/3 at 35. You may use any age or combination of ages that you choose.

Enter ages and fractions

CHILDREN/BENEFICIARIES

PLAN OF DISTRIBUTION