Will Questionnaire
Person 1 Name
First Name
Last Name
Person 1 Date of Birth
-
Month
-
Day
Year
Date
Person 2 Name
First Name
Last Name
Person 2 Date of Birth
-
Month
-
Day
Year
Date
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Email
example@example.com
Children Names & Their Date of Birth
Heading
Primary:
This is your first choice.
Successor:
This is your second choice if primary is incapacitated.
III. Key Decision Makers (Fiduciaries)
Select individuals you trust for the following roles. We recommend naming a primary and at least one backup.
The Executor / Trustee
Responsible for managing trust assets and distributing your estate after death.
Primary
First Name
Last Name
Successor
First Name
Last Name
Financial Power of Attorney
Handles your financial affairs if you become incapacitated while still alive.
Primary
First Name
Last Name
Successor
First Name
Last Name
Healthcare Agent (Medical Power of Attorney)
Makes medical decisions if you are unable to speak for yourself.
Primary
First Name
Last Name
Successor
First Name
Last Name
IV. Asset & Distribution Summary
Real Estate: (Primary residence, vacation homes, etc.)
Specific Bequests: (e.g., "I want my vintage watch to go to my nephew, Mark.")
Any other assets that you want listed?
The "Residue": (Who gets the remaining balance of the estate?)
Everything to Spouse, then Children equally.
Split by percentage.
If "Split by percentage" what is that percentage?
End-of-Life Wishes
Life Support: If in a terminal state, I wish to:
Be kept comfortable but allow natural death.
Use all available means to prolong life.
Final Disposition:
Burial
Cremation
Other
Disclaimer: This questionnaire is for informational purposes and does not constitute an attorney-client relationship until a formal agreement is signed.
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