PREPARING YOUR LAST WILL & TESTAMENT AND RELATED DOCUMENTS.

WILL QUESTIONNAIRE

• This questionnaire is being provided here on our website for your convenience.
• You will need to print this questionnaire (it is formatted for legal size paper,) answer all questions completely and mail this to our office in order for you to provide us the information necessary to advise you appropriately regarding your estate plan and in order for us to accurately prepare your Last Will & Testament and related documents.
• Alternately, you may copy and paste this entire page into your email client (Verizon, Comcast, MSN, etc.,) fill in the blanks and email the completed questionnaire to our office at JMAdamsesq@verizon.net
• Please write “N/A” in spaces which are not applicable to your situation. Thank you.
• If you are married, both you and your spouse should each have Wills prepared. 
• Where an address is requested, be complete: street number and name, apartment or unit number if applicable, city, state and zip code. 
• Our fees for preparation of wills and related documents are dependent on the number of documents and extensiveness of each. Fees can range from $295.00 to $2,000.00. Please call or email us for an estimate to prepare your specific documents.

NOTE that your estate may be subject to a Federal Estate Taxation if the Net Value (Total Assets minus ALL of your liabilities) exceeds $2,000,000.00; and $3,500,000.00 in 2010. If your Net Estate exceeds or is close to these amounts, please call us for special tax planning as a basic Will does not address these special needs. *****

TODAY’S DATE___________________________________________________

I. PERSONAL INFORMATION (PLEASE PRINT CLEARLY)

1) Answer completely:  legal name (include middle initials,) social security number, mail address (city, state, zip code,) phone numbers, marital status:

NAME______________________________________________________________

ANY OTHER NAMES USED_____________________________________________

DATE OF BIRTH___________SOCIAL SECURITY NUMBER____________________

ADDRESS___________________________________________________________

HOW LONG LIVING AT THIS ADDRESS____________________________________

HOME TELEPHONE#___________________CELL PHONE#___________________

EMAIL ADDRESS_____________________________________________________

MARITAL STATUS: [ ]Single [ ]Married [ ]Divorced [ ]Separated [ ]Widowed

CITIZENSHIP__________________________________________________________

ANY EXISTING WILLS? [ ] YES [ ] NO; IF YES, WHERE LOCATED_______________

_____________________________________________________________________

2) ARE YOU MARRIED? [ ] YES [ ] NO;

IF YES, NAME OF SPOUSE________________________________________________

ANY OTHER NAMES USED BY SPOUSE_____________________________________

DATE AND PLACE OF MARRIAGE__________________________________________

SPOUSE DATE OF BIRTH_________________________________________________

SPOUSE SOCIAL SECURITY NUMBER______________________________________

SPOUSE CITIZENSHIP____________________________________________________

DOES SPOUSE HAVE ANY WILLS? [ ] YES [ ] NO; IF YES, WHERE LOCATED________

______________________________________________________________________

3) PRIOR MARRIAGES? [ ] YES [ ] NO;

IF YES , NAME OF FORMER SPOUSE _______________________________________

DATE OF PRIOR MARRIAGE_______________________________________________

DATE AND PLACE OF MARRIAGE DISSOLUTION AND/OR JUDGMENT OF DIVORCE

_______________________________________________________________________

4) DO YOU HAVE ANY CHILDREN? [ ] YES [ ] NO IF YES, complete all information requested:

CHILDREN OF CURRENT MARRIAGE, IF ANY:

NAME __________________________________________________

AGE_____ DATE OF BIRTH__________ (check one:) [ ] MALE OR [ ] FEMALE

SOCIAL SECURITY NUMBER_________________________________________

MARITAL STATUS: [ ]Single [ ]Married [ ]Divorced [ ]Separated [ ]Widowed

ADDRESS__________________________________________________________ 

NAME __________________________________________________

AGE_____ DATE OF BIRTH__________ (check one:) [ ] MALE OR [ ] FEMALE

SOCIAL SECURITY NUMBER_________________________________________

MARITAL STATUS: [ ]Single [ ]Married [ ]Divorced [ ]Separated [ ]Widowed

ADDRESS__________________________________________________________

NAME __________________________________________________

AGE_____ DATE OF BIRTH__________ (check one:) [ ] MALE OR [ ] FEMALE

SOCIAL SECURITY NUMBER_________________________________________

MARITAL STATUS: [ ]Single [ ]Married [ ]Divorced [ ]Separated [ ]Widowed

ADDRESS__________________________________________________________

(List additional children on back or on separate sheet)

ADOPTED CHILDREN, IF ANY

NAME __________________________________________________

AGE_____ DATE OF BIRTH__________ (check one:) [ ] MALE OR [ ] FEMALE

SOCIAL SECURITY NUMBER_________________________________________

MARITAL STATUS: [ ]Single [ ]Married [ ]Divorced [ ]Separated [ ]Widowed

ADDRESS__________________________________________________________

NAME __________________________________________________

AGE_____ DATE OF BIRTH__________ (check one:) [ ] MALE OR [ ] FEMALE

SOCIAL SECURITY NUMBER_________________________________________

MARITAL STATUS: [ ]Single [ ]Married [ ]Divorced [ ]Separated [ ]Widowed

ADDRESS__________________________________________________________

(List additional children on back or on separate sheet.)

CHILDREN OF PRIOR MARRIAGE, IF ANY

NAME __________________________________________________

AGE_____ DATE OF BIRTH__________ (check one:) [ ] MALE OR [ ] FEMALE

SOCIAL SECURITY NUMBER_________________________________________

MARITAL STATUS: [ ]Single [ ]Married [ ]Divorced [ ]Separated [ ]Widowed

ADDRESS__________________________________________________________

NAME __________________________________________________

AGE_____ DATE OF BIRTH__________ (check one:) [ ] MALE OR [ ] FEMALE

SOCIAL SECURITY NUMBER_________________________________________

MARITAL STATUS: [ ]Single [ ]Married [ ]Divorced [ ]Separated [ ]Widowed

ADDRESS__________________________________________________________

GRANDCHILDREN, IF ANY

NAME __________________________________________________

AGE_____ DATE OF BIRTH__________ (check one:) [ ] MALE OR [ ] FEMALE

SOCIAL SECURITY NUMBER_________________________________________

MARITAL STATUS: [ ]Single [ ]Married [ ]Divorced [ ]Separated [ ]Widowed

ADDRESS__________________________________________________________

NAME __________________________________________________

AGE_____ DATE OF BIRTH__________ (check one:) [ ] MALE OR [ ] FEMALE

SOCIAL SECURITY NUMBER_________________________________________

MARITAL STATUS: [ ]Single [ ]Married [ ]Divorced [ ]Separated [ ]Widowed

ADDRESS__________________________________________________________

NAME __________________________________________________

AGE_____ DATE OF BIRTH__________ (check one:) [ ] MALE OR [ ] FEMALE

SOCIAL SECURITY NUMBER_________________________________________

MARITAL STATUS: [ ]Single [ ]Married [ ]Divorced [ ]Separated [ ]Widowed

ADDRESS__________________________________________________________

NAME __________________________________________________

AGE_____ DATE OF BIRTH__________ (check one:) [ ] MALE OR [ ] FEMALE

SOCIAL SECURITY NUMBER_________________________________________

MARITAL STATUS: [ ]Single [ ]Married [ ]Divorced [ ]Separated [ ]Widowed

ADDRESS__________________________________________________________

(List additional children on back or on separate sheet.)

5) OTHER RELATIVES :                        PARENTS

                                                                                YOURS / OF SPOUSE

FATHER’S NAME & AGE______________________/_____________________

ADDRESS______________________________/_____________________________

                                 [ ] LIVING [ ] DECEASED              [ ] LIVING [ ] DECEASED

MOTHER’S NAME & AGE_________________________/_________________________

ADDRESS__________________________/_____________________________

                                 [ ] LIVING [ ] DECEASED              [ ] LIVING [ ] DECEASED

6) OTHER RELATIVES INCLUDED IN WILL (BROTHERS, SISTERS, GRANDPARENTS, AUNTS, UNCLES, NIECES, NEPHEWS, ETC.)  (PLEASE PROVIDE COMPLETE NAMES, DATES OF BIRTH, ADDRESSES, SOCIAL SECURITY NUMBERS, AND MARITAL STATUS OF EACH PERSON LISTED .)

___________________________________________________________________________________________________________________________________

___________________________________________________________________________________________________________________________________

7) SPECIAL MEDICAL OR FINANCIAL NEEDS OF SELF, SPOUSE, AND/OR DEPENDENTS (BE AS SPECIFIC AS POSSIBLE)

______________________________________________________________________________________________________

______________________________________________________________________________________________________

II. ASSETS

(1) STOCKS, BONDS, AND/OR OTHER SECURITIES AND HOW REGISTERED (JOINT – SURVIVORSHIP – P.O.D. – TRUST – CUSTODIAL) (LIST ALL)_________________________________________________________________________________________________________________________

__________________________________________________________________________________________________________________________________

(2) REAL ESTATE: LOCATION, DESCRIPTION, RECORD OWNERS, HOW AND WHEN ACQUIRED, ESTIMATED VALUE, MORTGAGES. (LIST ALL)

__________________________________________________________________________________________________________________________________

__________________________________________________________________________________________________________________________________

(3) INSURANCE POLICIES, PENSIONS, RETIREMENT AND DEATH BENEFITS.(IDENTIFICATION AND BENEFICIARY) (LIST ALL)

__________________________________________________________________________________________________________________________________

__________________________________________________________________________________________________________________________________

(4) BUSINESS AFFILIATIONS AND INTERESTS. (PROVIDE DETAILS)_____________________________________________

_____________________________________________________________________________________________________

(5) EXPECTANCIES: INHERITANCES, GIFTS EXPECTED (PROVIDE DETAILS) _____________________________________

_____________________________________________________________________________________________________

(6) PERSONAL EFFECTS: JEWELRY, FURS, FINE ART, CASH ON HAND, OTHER ITEMS OF SUBSTANTIAL VALUE (PROVIDE DETAILS AND VALUES) _________________________________________________________________________________________________________________________

_____________________________________________________________________________________________________

_____________________________________________________________________________________________________

(7) BANK, SAVINGS & LOAN, CHECKING, CREDIT UNION ACCOUNTS AND HOW REGISTERED ( INDIVIDUAL, JOINT, SURVIVORSHIP, CUSTODIAL, TRUST ) (PROVIDE BANK NAME, ADDRESS AND ACCOUNT NUMBERS FOR EACH)

                     Type of account      account number      how registered       bank name/address

a)___________________________________________________________________________________________________

b)___________________________________________________________________________________________________

c)___________________________________________________________________________________________________

d)___________________________________________________________________________________________________

(List additional accounts on other side or separate sheet.)

(8) SAFE DEPOSIT BOX(ES) (LOCATION AND HOW REGISTERED)______________________________________________

____________________________________________________________________________________________________

(9) OTHER INVESTMENTS (NATURE, HELD IN WHAT NAME)___________________________________________________

____________________________________________________________________________________________________

(10) LIABILITIES _______________________________________________________________________________________

____________________________________________________________________________________________________

(11) ESTIMATED GROSS ESTATE $_________________________________

III. ESTATE EXECUTOR/EXECUTRIX

• The person who is legally responsible for the administration of your estate, marshaling your assets, paying estate debts and taxes, and distributing your estate to designated beneficiaries is called an Executor or Executrix.
• This person should be someone in whom you have complete trust and confidence.
• If you are married, the logical choice for Executor is your spouse (and vice-versa.)
• However, it is also important to name an alternate or second (2^nd) choice who will act if your first choice has predeceased you or is otherwise unable to act.

1) First choice as Executor/Executrix:

NAME_________________________________RELATIONSHIP__________________

ADDRESS____________________________________________________________________________

2) Second choice as Executor/Executrix:

NAME_________________________________RELATIONSHIP_____________

ADDRESS_____________________________________________________________________________

IV. DISTRIBUTION OF YOUR ESTATE

• You may distribute your estate in any way you like, within certain legal parameters.
• Most notably, spouses CANNOT be disinherited.
• A disinherited spouse has the right to claim what is called an “Elective Share” in the estate, which would entitle him/her to approximately one-third (1/3.)
• Children CAN be disinherited. However, if you wish to disinherit any child, you must mention him/her in your Will or the law will presume you intended to include them and simply forgot.
• In the ordinary course of events, spouses usually leave their entire estate to the surviving spouse, or if there is no surviving spouse, to their children and/or grandchildren.
• See Section V. “Guardianship” that details provisions for minor children and/or grandchildren.
• Lastly, you have the right but are not required to make specific bequests of property (such as jewelry or collectibles) or money to any beneficiary.

1) Do you wish to make any specific bequests to any beneficiary? [ ] YES [ ] NO     IF YES, SPECIFY IN SECTION “E”

2) To whom do you wish your estate distributed?

     (A) I want my entire estate to go to my surviving SPOUSE EXCEPT for the specific bequests detailed in SECTION “E”, if any:

                     [ ] YES [ ] NO

     (B) Please indicate how you wish your estate distributed if at the time of your death your spouse has predeceased you, or if you are unmarried, but have children:

                     [ ] SURVIVING CHILDREN [ ] CHARITY(IES) [ ] OTHER                     

                     IF you checked CHARITY(IES) and/or OTHER, list the complete names, complete addresses and other relevant information:

______________________________________________________________________________________________________

     (C) If all or a part of your estate may be distributed to your children, it is important you indicate what you wish done in the event any of your children has predeceased you at the time of your death.

                    [ ] YES, I would like the portion of my estate left to any of my children to pass to his/her child(ren) if any such of my children has predeceased me.

                    [ ] YES, I would like any predeceased child’s portion to be divided among any of my other surviving children only.

                    [ ] Other (please explain:)_______________________________________________________________________________

       (D) If you are unmarried and/or have no children, please indicate how and to whom you wish your estate to be distributed:_____________________________________________________________________________________________

______________________________________________________________________________________________________

  (E) SPECIFIC DISPOSITION OF ESTATE

• DESIGNATE SPECIFIC ITEMS OF PERSONALTY SUCH AS JEWELRY, FURS, WORKS OF ART, SILVERWARE, CHINA, ETC. 
• WHERE SHARES OF STOCK ARE BEQUEATHED, INDICATE IF INCREMENTS, SPLITS, MERGERS AND SUBSTITUTIONS ARE INCLUDED. 
• WHERE INCOME OF STOCK IS BEQUEATHED, INDICATE IF CASH DIVIDENDS ARE INCLUDED. (BE AS COMPLETE AS POSSIBLE.)

1) TO SPOUSE_________________________________________________________________________________________

______________________________________________________________________________________________________

______________________________________________________________________________________________________

SPECIAL CONDITIONS OR CONTINGENCIES ______________________________________________________________________________________________________

2) TO______________________________________RELATIONSHIP_______________________

ADDRESS_______________________________________________________________________

IF UNDER 18 , AGE ______ SOCIAL SECURITY NUMBER______________________________

LEGACY (INCLUDE ANY CONDITIONS OR CONTINGENCIES) ___________________________________________________________________________________________

___________________________________________________________________________________________

3) TO______________________________________RELATIONSHIP_______________________

ADDRESS_______________________________________________________________________

IF UNDER 18 , AGE ______ SOCIAL SECURITY NUMBER______________________________

LEGACY (INCLUDE ANY CONDITIONS OR CONTINGENCIES) ___________________________________________________________________________________________

___________________________________________________________________________________________

4) TO______________________________________RELATIONSHIP_______________________

ADDRESS_______________________________________________________________________

IF UNDER 18 , AGE ______ SOCIAL SECURITY NUMBER______________________________

LEGACY (INCLUDE ANY CONDITIONS OR CONTINGENCIES) ___________________________________________________________________________________________

___________________________________________________________________________________________

5) TO______________________________________RELATIONSHIP_______________________

ADDRESS_______________________________________________________________________

IF UNDER 18 , AGE ______ SOCIAL SECURITY NUMBER______________________________

LEGACY (INCLUDE ANY CONDITIONS OR CONTINGENCIES) _____________________________________________________________________________________________________

_____________________________________________________________________________________________________

6) TO______________________________________RELATIONSHIP_______________________

ADDRESS_______________________________________________________________________

IF UNDER 18 , AGE ______ SOCIAL SECURITY NUMBER______________________________

LEGACY (INCLUDE ANY CONDITIONS OR CONTINGENCIES) _____________________________________________________________________________________________________

_____________________________________________________________________________________________________       (For additional space, please use other side or separate sheet.)

7) RESIDUARY ESTATE – CONTINGENCIES OVER (EXONERATION OF MORTGAGE) _____________________________________________________________________________________________________

8) DISPOSITION OF LOANS OR ADVANCES MADE OR TO BE MADE

_____________________________________________________________________________________________________

9) EXERCISE OF POWERS OF APPOINTMENT OR DISPOSITION

_____________________________________________________________________________________________________

10) PROVISIONS REGARDING GIFTS OR BEQUESTS TO MINORS OR INCOMPETENTS

_____________________________________________________________________________________________________

11) CHARITABLE BEQUESTS_____________________________________________________________________________

12) PAYMENTS OF INHERITANCE – ESTATE – DEATH TAXES __________________________________________________

_____________________________________________________________________________________________________

13) FUNERAL, BURIAL, MONUMENT, SERVICES, GRAVE CARE, ETC. ____________________________________________

_____________________________________________________________________________________________________

V. GUARDIANSHIP FOR MINOR CHILDREN

• If you have minor children (under the age of 18) you must provide for who will be the child(ren)’s Legal Guardian in the event of your untimely death.
• A surviving parent normally has the legal right to continue as the child’s Guardian.
• However, it is wise to plan for what happens in the event the other parent predeceases you, or if you perish simultaneously in a common tragedy.
• The Legal Guardian will normally have custody of the child(ren)and act as parent in your place.
• To properly plan for such an eventuality, it is important to select a Guardian (first/1^st choice) and Alternate Guardian (second/2^nd choice.)

1) My choice of Guardian:

NAME_________________________________RELATIONSHIP______________

ADDRESS________________________________________________________

2) My choice of Alternate Guardian:

NAME_________________________________RELATIONSHIP______________

ADDRESS________________________________________________________

VI. TRUSTEE

• If you have minor children, or a portion of your estate could go to a minor grandchild, it will be necessary to name a Trustee and Alternate Trustee.
• The Trustee is responsible for the child(ren)’s finances and managing the assets left to the child(ren) and to ensure that the child(ren)’s basic needs are provided for, including health, education and general welfare.
• The Trustee and Guardian for your child(ren) can, but is not required to be, the same person.
• When selecting a Trustee, it is important to indicate the age at which you wish the Trust to terminate or end.
• When the Trust ends, whatever is left in the Trust will be distributed to the beneficiary for whom the Trust was created. It then becomes his/hers absolutely and completely.
• We recommend that the age of termination be twenty-five (25.) This usually enables the beneficiary to conclude any schooling and to be at a reasonably mature age when he/she receives the balance of assets in the Trust. However, you can designate any age you wish.

1) My choice of Trustee:

NAME_________________________________RELATIONSHIP_______________

ADDRESS_________________________________________________________                                                                                

2) My choice of Alternate Trustee:

NAME_________________________________RELATIONSHIP_______________

ADDRESS_________________________________________________________ 

a. I wish that any Trust created terminate/end when each beneficiary has reached the age of ______.

VII. SPECIAL CIRCUMSTANCES

If there are any other special circumstances, such as a handicapped child for whom you wish to make provisions or any other matter about which you have questions or would like to address, please list below or contact our office with questions.

_____________________________________________________________________________________________The end

X_________________________________________ X__­­________________                             

               Your Signature Here                                              today’s date

Please complete this entire questionnaire and return to our office. Thank you.

* This document is designed for general information only. The information presented here should not be construed to be formal, legal advice nor the formation of a lawyer/client relationship. For a questions pertaining to this topic or a Free Legal Consultation, please call Jeffrey M. Adams Law Firm at 732 281 3005.

JEFFREY M. ADAMS

ATTORNEY AT LAW

Toms River, New Jersey 08753

Phone: 732 281 3005

Fax: 732 281 3006

Email: JMAdamsesq@verizon.net 

Website: www.JMAdamsLawFirm.com 

© Jeffrey M. Adams, January 2007

All rights reserved. You may copy this document for your own personal use with proper credit given the author and copyright information included. You may not copy and distribute this material for commercial purposes without the express written consent of the author.