Estate Planning Questionnaire Client InformationFull Name(Required)SSNPhone(Required)Email(Required) Date of Birth MM slash DD slash YYYY Place of BirthCitizenshipAddress Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Do you have children? Yes No Do you intend to leave everything outright to your spouse, and then equally to children (if you have children)? Yes No If No, we will discuss with you in more detail.Do you have a retirement account (401k, IRA, etc)? Yes No Do you have a business? Yes No Do you have Estate Planning documents?If Yes, bring these with you Yes No Are those documents over 3 years old?If Yes, bring these with you Yes No ChildrenChild's NameBirthday MM slash DD slash YYYY GenderTypeBiologicalAdoptedStepchildChild's NameBirthday MM slash DD slash YYYY GenderTypeBiologicalAdoptedStepchildChild's NameBirthday MM slash DD slash YYYY GenderTypeBiologicalAdoptedStepchildChild's NameBirthday MM slash DD slash YYYY GenderTypeBiologicalAdoptedStepchildRetirement AccountIdentificationCurrent ValueOwnerBeneficiaryIdentificationCurrent ValueOwnerBeneficiaryBusiness InformationBriefly describe your business including your estimated yearly net income (except business primarily holding real estate).For Your EstateAnswer the following to the best of your ability. You can change your answer at any time. You may name more than one person to serve in any position (e.g. Co-executors) Who would you name to be…1st Executor of your Estate:1st Guardian for Minor Children:1st Trustee of your Estate:1st A person to handle your financial affairs if you can’t1st A person to care for you if you can’t care for yourself2nd Executor of your Estate:2nd Guardian for Minor Children:2nd Trustee of your Estate:2nd A person to handle your financial affairs if you can’t2nd A person to care for you if you can’t care for yourself3rd Executor of your Estate:3rd Guardian for Minor Children:3rd Trustee of your Estate:3rd A person to handle your financial affairs if you can’t3rd A person to care for you if you can’t care for yourselfFor Your Spouse's EstateAnswer the following to the best of your ability. You can change your answer at any time. You may name more than one person to serve in any position (e.g. Co-executors) Who would you name to be…1st Executor of your Estate:1st Guardian for Minor Children:1st Trustee of your Estate:1st A person to handle your financial affairs if you can’t1st A person to care for you if you can’t care for yourself2nd Executor of your Estate:2nd Guardian for Minor Children:2nd Trustee of your Estate:2nd A person to handle your financial affairs if you can’t2nd A person to care for you if you can’t care for yourself3rd Executor of your Estate:3rd Guardian for Minor Children:3rd Trustee of your Estate:3rd A person to handle your financial affairs if you can’t3rd A person to care for you if you can’t care for yourself We are glad that you found us, and are looking forward to working with you.
