ESTATE PLANNING QUESTIONNAIRE

Vance E. Hendrix, PC vance@vancehendrixattorney.com 903.944.7800

Date*

Date

Legal Name

Address*

County of Residence

Email Address*

example@example.com

Telephone*

Date of Birth

Date

Are you a US Citizen?

Spouse's Legal Name

Email Address

example@example.com

Telephone

Date of Birth

Date

Is your Spouse a US Citizen?

List all of your living children (Name, age, gender, address).

List all deceased children.

Have you adopted any children

Have you treated any non– biological children as your own?

Do any of your children have special needs or receive government benefits?

If yes please provide a brief explanation

Have you or do you expect to inherit any property?

Do you have any frozen genetic material in storage?

Real Estate & Mineral Interests. For each tract of real property (including minerals), list the address, and county (and state if outside of Texas

Cash/Savings. For each account, list the bank name, the beneficiaries (if any), and estimated value.

Stocks, Bonds, Mutual Funds (excluding those held in retirement accounts). For each account, list the institution name, the beneficiaries, and estimated value.

Retirement Accounts, 401(k), Pension plans, Annuities, IRAs. For each account, list the institution name, the beneficiaries, and estimated value.

Business Interests. For each business, list the legal name, ownership, and value.

Life Insurance. For each policy, list the beneficiaries, and estimated cash value.

Digital Assets (cryptocurrency, bitcoin, NFTs, etc. Describe generally and include estimated value.

Estimated total value of your estate.

Is any of your property separate property?

Distribution of your estate. At our meeting be prepared to discuss how your estate should be distributed upon your death, keeping in mind any contingent beneficiaries if a primary beneficiary does not survive you. Describe the distribution of your assets upon your death including any specific gifts to individuals or charity

Burial and Cremation Instructions. If you wish to include (1) burial or cremation instructions or (2) rights to the disposition of your remains, describe such instructions below.

Executor. List the name, address, and telephone number of each person (or bank/trust company) that will serve as Executor. Please list alternates at least 2 alternates for each. Executor is the individual that will probate your Will.

Should your Executor be paid?

Trustees. List the name, address, and telephone of the Trustee. The Trustee is the individual (or institution) that will manage your Trust (Note, you may not have a trust depending on your specific estate plan.

Should your Trustee be paid?

Agents (Power of Attorney) - The individual(s) that will make decisions for you during your lifetime, if you are unable to make decisions for yourself.

Financial Agents - Power of Attorney

Medical Agents - Power of Attorney

Should your Agents be paid?

Do you have a premarital or prenuptial agreement?

Have you made any gifts of more than $19,000 in any calendar year?

Have you ever filed a Gift Tax return (Form 709)?

Are you subject to an ongoing obligation to a former spouse (alimony, child support, etc.?

Are you the current beneficiary of a trust?

Are you a current or potential party to a lawsuit?

Have you created a list or database of your automatic draft payments?

Have you created a list or database of your passwords for digital accounts?

Have you left any written instructions for your family upon your passing??

If you have minor (under 18) children, please identify who you wish to be the Guardian for your minor children.