Estate Planning Questionnaire for Married Couples - Tyler Probate Attorney l Vance E. Hendrix P.C.

New Client - Estate Planning Questionnaire for Married Couples

THE INFORMATION IN THIS DOCUMENT IS SUBJECT TO THE ATTORNEY-CLIENT PRIVILEGE, AS PROVIDED IN THE TEXAS RULES OF EVIDENCE. THE CONTENTS OF THIS DOCUMENT ARE CONFIDENTIAL AND WILL NOT TO BE DISCLOSED TO THIRD PERSONS OTHER THAN IN FURTHERANCE OF PROFESSIONAL LEGAL SERVICES.

PLEASE COMPLETE THE FOLLOWING.

Clear Form

List all names as you wish them to appear in legal documents

SPOUSE #1

Name

Address

Telephone

Work Phone

Date of Birth

E-mail

Social Security #

Employer

Driver’s License #

Position/Title

U.S. Citizen? YesNo

SPOUSE #1’S MARITAL HISTORY

List Marriages (name of spouse, date of marriage/divorce/death).

DivorceDeath

Date of Divorce or Death:

DivorceDeath

Date of Divorce or Death:

DivorceDeath

Date of Divorce or Death:

DivorceDeath

Date of Divorce or Death:

Is Spouse #2 your primary beneficiary? YesNo

If No, explain

Do you have a premarital agreement? YesNo

SPOUSE #2

Name

Address

Telephone

Work Phone

Date of Birth

E-mail

Social Security #

Employer

Driver’s License #

Position/Title

U.S. Citizen? YesNo

SPOUSE #2’S MARITAL HISTORY

List Marriages (name of spouse, date of marriage/divorce/death).

DivorceDeath

Date of Divorce or Death:

DivorceDeath

Date of Divorce or Death:

DivorceDeath

Date of Divorce or Death:

DivorceDeath

Date of Divorce or Death:

Is Spouse #1 your primary beneficiary? YesNo

If No, explain

Do you have a premarital agreement? YesNo

Do you or your Spouse have a Last Will and Testament? YesNo

Do you or your spouse have a Trust or are you the beneficiary of a Trust? YesNo

Have you or your spouse made any gifts in excess of $15,000.00 to any individual during any one calendar year? YesNo

Have you or your spouse ever filed a Gift Tax return (Form 709)? YesNo

CHILDREN

List all children, living or deceased; list their names as you wish them to appear in legal documents. If you wish to exclude a child, please make an appropriate indication.

Full Name

Date of Birth

Age

Address

Full Name 1

Date of Birth 1

Age 1

Address 1

Full Name 2

Date of Birth 2

Age 2

Address 2

Full Name 3

Date of Birth 3

Age 3

Address 3

Full Name 4

Date of Birth 4

Age 4

Address 4

Full Name 5

Date of Birth 5

Age 5

Address 5

Full Name 6

Date of Birth 6

Age 6

Address 6

Full Name 7

Date of Birth 7

Age 7

Address 7

Explain:

YOUR ESTATE

Describe to whom you wish your Estate to pass upon your death, including any specific gifts.

Do any of the Beneficiaries have special needs or receive government benefits? YesNo

Explain:

CHARITABLE BEQUESTS

Describe any charitable bequests you wish to make, including any specific bequests to charity.

BURIAL AND CREMATION INSTRUCTIONS BEQUESTS

If you wish to include burial or cremation instructions in your estate planning documents, please describe such burial or cremation instructions below.

DESIGNATION OF GUARDIAN FOR MINORS

If you have a child under the age of 18 and wish to designate a person or persons to serve as guardian for such child, please identify the person or persons below, including their name, address, and telephone number.

SPOUSE #1’S EXECUTORS AND TRUSTEES

EXECUTORS

Name

Address

Telephone #

Name

Address

Telephone

Name

Address

Telephone

Name

Address

Telephone

Name

Address

Telephone

TRUSTEES

Name

Address

Telephone #

Name

Address

Telephone

Name

Address

Telephone

Name

Address

Telephone

Name

Address

Telephone

SPOUSE #2’S EXECUTORS AND TRUSTEES

CHECK HERE IF SAME AS HUSBAND’S: Yes

EXECUTORS

Name

Address

Telephone #

Name

Address

Telephone

Name

Address

Telephone

Name

Address

Telephone

Name

Address

Telephone

TRUSTEES

Name

Address

Telephone #

Name

Address

Telephone

Name

Address

Telephone

Name

Address

Telephone

Name

Address

Telephone

SPOUSE #1’S POWERS OF ATTORNEY

Please identify the individuals that you wish to serve as your agents below.

MEDICAL POWER OF ATTORNEY

Name

Address

1st Agent:

Name

Address

2nd Agent:

Name

Address

3rd Agent:

Name

Address

DURABLE POWER OF ATTORNEY

Name

Address

1st Agent:

Name

Address

2nd Agent:

Name

Address

3rd Agent:

Name

Address

SPOUSE #2’S POWERS OF ATTORNEY

Please identify the individuals that you wish to serve as your agents below.

MEDICAL POWER OF ATTORNEY

Name

Address

1st Agent:

Name

Address

2nd Agent:

Name

Address

3rd Agent:

Name

Address

DURABLE POWER OF ATTORNEY

Name

Address

1st Agent:

Name

Address

2nd Agent:

Name

Address

3rd Agent:

Name

Address

PROFESSIONAL ADVISORS

Please identify your professional advisors

Accountant:

Insurance Agent:

Financial Advisor:

ASSETS

Estimated Net Worth:

Estimated Total Value of Community Property:

Estimated Total Value of Husband’s Separate Property:

Estimated Total Value of Wife’s Separate Property:

Does the total value of your Estate exceed $23,400,000.00 for a married couple (or $11,7000,000 for an individual)? YesNo

REAL ESTATE

For all Real Estate (Land/houses, etc., identify the Location/Address (include County of location).

Address

Equity

Value

Address 1

Equity 1

Value 1

Address 2

Equity 2

Value 2

Address 3

Equity 3

Value 3

Address 4

Equity 4

Value 4

Address 5

Equity 5

Value 5

Address 6

Equity 6

Value 6

OIL, GAS, AND MINERAL INTERESTS

For all oil, gas, and minerals that you own, identify the county in which such minerals are located.

BANKS AND BROKERAGE ACCOUNTS

Identify all Institutions at which you maintain an account.

Name of Bank/Brokerage Firm

Acct #

Beneficiary Designations

Value

Name of Bank/Brokerage Firm 1

Acct 1

Beneficiary Designations 1

Value 1

Name of Bank/Brokerage Firm 2

Acct 2

Beneficiary Designations 2

Value 2

Name of Bank/Brokerage Firm 3

Acct 3

Beneficiary Designations 3

Value 3

Name of Bank/Brokerage Firm 4

Acct 4

Beneficiary Designations 4

Value 4

Name of Bank/Brokerage Firm 5

Acct 5

Beneficiary Designations 5

Value 5

Name of Bank/Brokerage Firm 6

Acct 6

Beneficiary Designations 6

Value 6

Name of Bank/Brokerage Firm 7

Acct 7

Beneficiary Designations 7

Value 7

Name of Bank/Brokerage Firm 8

Acct 8

Beneficiary Designations 8

Value 8

Name of Bank/Brokerage Firm 9

Acct 9

Beneficiary Designations 9

Value 9

OTHER ASSETS (Business interests, Retirement Accounts, Digital Assests such as bitcoin, Trademarks, Patents, Copyrights, etc.)

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

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

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