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Estate Planning Questionnaire

Estate Planning Questionnaire

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Published by danjackson7
Estate Planning Questionnaire
Estate Planning Questionnaire

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Published by: danjackson7 on Jul 27, 2009
Copyright:Attribution Non-commercial

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07/19/2010

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ESTATE PLANNING QUESTIONNAIRE
(CONFIDENTIAL)ESTATE PLANNING DATA
Date: ______________________________________
A. PERSONAL
Husband Wife
1. Name _________________________________________  _________________________________________ 2. Other Names _________________________________________  _________________________________________ 3. Addressesa. Home _________________________________________  _________________________________________  _________________________________________  _________________________________________ b. Mailing _________________________________________  _________________________________________  _________________________________________  _________________________________________ 4. Telephonea. Home _________________________________________  _________________________________________ b. Work _________________________________________  _________________________________________ 5. Birth Date _________________________________________  _________________________________________ 6. Place of Birth _________________________________________  _________________________________________ 
E
STATE
P
LANNING
Q
UESTIONNAIRE
- 1 -D
ANIEL
J
ACKSON
-
ATTORNEY
 
AT
 
LAW
 
7. Social Security No_________________________________________  _________________________________________ 8. Marriage Date _________________________________________  _________________________________________ 9. Marriage Place _________________________________________  _________________________________________ 10. Citizenship _________________________________________  _________________________________________ 11. Other _________________________________________  _________________________________________ 
E
STATE
P
LANNING
Q
UESTIONNAIRE
- 2 -D
ANIEL
J
ACKSON
-
ATTORNEY
 
AT
 
LAW
 
B.PRIOR MARRIAGES
(
In the event of divorce, please provide a copy of theDecree of Dissolution and any related agreements.)
Husband Wife
1. Former Spouse ________________________________________  _________________________________________ 2. Marriage Date ________________________________________  _________________________________________ 3. Date Marriage Terminated:a. By Divorce ________________________________________  _________________________________________ b. By Death________________________________________  _________________________________________ 4. Obligations to orfrom former spouse________________________________________  _________________________________________ 5. Child Support ________________________________________  _________________________________________ 6. SeparateMaintenance ________________________________________  _________________________________________ 
C.CHILDREN
Please indicate if child is of prior marriage. All of your children and allchildren of any deceased child must be named in your Will, even though you leavethem nothing.
 
Husband Wife
1. Living Children:a. Name________________________________________ _________________________________________ Birth Date________________________________________ _________________________________________ b. Name _________________________________________  _________________________________________ 
E
STATE
P
LANNING
Q
UESTIONNAIRE
- 3 -D
ANIEL
J
ACKSON
-
ATTORNEY
 
AT
 
LAW

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