Estate Planning Worksheet

Estate Planning Worksheet

Thank you for choosing us for your estate planning needs. Please fill out this questionnaire to help us understand your requirements. Your privacy is our top priority. All information you provide will be held in strict confidence and secured with advanced protection measures.
Personal Information
Full Name*

First NameLast Name
Date of Birth*

MonthDayYear
Date
Are you a U.S. Citizen?

YesNo
Phone Number
Please enter a valid phone number.
Email Address
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Marital Status

SingleMarriedDivorcedWidowed

Family Information
List of Family Members - (Spouse, Children, Etc...)
Are any of your children or intended beneficiaries physically or mentally challenged?

YesNo
Do any of your children or intended beneficiaries have any special education, medical or financial needs?

YesNo
Please Give Details

Property/Asset Information

This Property Information checklist is to help you list all the property you own and what it is worth. You probably won’t own property under all the headings; if not, just leave those blank.
Real Property
Any interest in real estate including your family residence, vacation home, time share, vacant land, etc.
Furniture and Personal Effects
List separately only major personal effects such as jewelry, collections, antiques, furs, and all other valuable non-business personal property
Automobile, Boats, and RVs
List separately each motor vehicle, boat, RV, etc. owned
Bank & Investment Accounts
List any and all Checking Accounts, Savings Accounts, Certificates of Deposits, Money Markets, Stocks, and Bonds you own. Do not include IRAs or 401(k)s here
Life Insurance Policies and Annuities
List all Life Insurance and Annuities you own.
Retirement Plans
List any and all Retirement Plans
Business Interest
If you have any ownership interest in any business, list them here along with the estimated value of ownership

	High Concern	Some Concern	Low Concern	No Concern or N/A
Desire to get affairs in order and create a comprehensive plan to manage affairs in case of death or disability.
Providing for and protecting children.
Providing for and protecting grandchildren.
Disinheriting a family member.
Providing for charities at the time of death.
Plan for the transfer and survival of a family business.
Avoiding or reducing your estate taxes.
Avoiding probate.
Avoiding a conservatorship (“living probate”) in case of a disability.
Avoiding will contests or other disputes upon death.
Protecting assets from lawsuits or creditors.
Preserving the privacy of affairs in case of disability or at time of death from business competitors, predators, dishonest persons and curiosity seekers.
Plan for a child with disabilities or special needs, such as medical or learning disabilities.
Protecting children’s inheritance from the possibility of failed marriages.
Provide that your death shall not be unnecessarily prolonged by artificial means or measures.

	Yes	No
Are you receiving Social Security, disability, or other governmental benefits?
Are you making payments pursuant to a divorce or property settlement order? Please furnish a copy
Have you been widowed? If a federal estate tax return or a state death tax return was filed, please furnish a copy
Have you ever filed federal or state gift tax returns? Please furnish copies of these returns
Have you completed a previous will, trust, or estate plan? Please furnish copies of these documents
Are you currently the beneficiary of anyone else’s trust? If so, please explain below.
Do you provide primary or other major financial support to adult children or others?

Personal Information