ESTATE PLANNING CHECKLIST - PAGE 1
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We will use the information you provide in this questionnaire:

1. To help you organize personal and financial information so that you can assess your current estate plans and evaluate whether changes are desired or required.
2. To help you evaluate our estate planning recommendations. The estate plan is your plan, not your lawyer's, and you must be satisfied that it is workable.

You may provide as much or as little information as you want. We recognize that this questionnaire is fairly intrusive. Keep in mind, however, that more complete information will better equip you and us throughout the planning process to come up with the best possible estate planning alternatives. Your information will be kept confidential by this office unless you authorize its release to others.

This form is on several pages in order to make it easier to complete and print. The form can be completed on the web site. When arriving at the bottom of each page, please print and then continue to the next page.

We ask that you bring copies of all of your important papers to your initial interview for reference. Those papers will be returned to you at the conclusion of the interview.

Personal and Family Information

State the names below exactly as you want them to appear in your will and other estate planning documents.

First Name: Middle Last

Nickname(s), assumed name(s), former name(s):

Address: City: State: Zip:

Mailing Address, if Different:

Phone: Home Work Fax Email

Birth date: Gender: M F Social Security #:

Current marital status: married unmarried

If married, date of current marriage: In what state were you married?

If you were not married in California, in what year did you move to California?

Any previous marriages? Yes No If yes, how many previous marriages?

Are you a U.S. citizen: Yes No
If no, are you a non-resident alien, i.e., a resident of another country? Yes No
If yes, what country?

Name of Spouse

First: Middle: Last:

Nickname(s), assumed name(s) or former name(s):

Spouse's Social Security #: Date of Birth:

Do you and your spouse have same residence and phone number? Yes No
If no, complete the following:
Spouse's address: City: State: Zip:
Phone: Home Work Fax Email

Personal Information About Spouse

Are there any previous marriages for client's spouse? Yes No
If yes, how many previous marriages?
Is client's spouse a U.S. citizen? Yes No
If no, is spouse a non-resident alien, that is, a resident of another country? Yes No

Information Regarding Previous Marriage(s) of CLIENT:

Name of former spouse:
This marriage terminated because of:
Divorce: Year of final decree:
Death: Date of former spouse's death:
Annulment: Year of final decree:

Name of former spouse:
This marriage terminated because of:
Divorce: Year of final decree:
Death: Date of former spouse's death:
Annulment: Year of final decree:

Name of former spouse:
This marriage terminated because of:
Divorce: Year of final decree:
Death: Date of former spouse's death:
Annulment: Year of final decree:

Information Regarding Previous Marriage(s) of SPOUSE:

Name of former spouse:
This marriage terminated because of:
Divorce: Year of final decree:
Death: Date of former spouse's death:
Annulment: Year of final decree:

Name of former spouse:
This marriage terminated because of:
Divorce: Year of final decree:
Death: Date of former spouse's death:
Annulment: Year of final decree:

Name of former spouse:
This marriage terminated because of:
Divorce: Year of final decree:
Death: Date of former spouse's death:
Annulment: Year of final decree:

Your Children, Their Spouses, and Their Children

Indicate which, if any, of your children is your child but not your spouse's, or vice versa. Also, please show the date of adoption of any adopted child. Be sure to include any deceased child and indicate the date of the child's death and his or her surviving spouse and/or children.

1. Child: Nickname: Date of Birth:
Address: City: State: Zip:
Phone: Child's spouse:
Is this child of the current marriage? Yes No
If no, name of child's other parent
Child's children(and their dates of birth):
(i)
(ii)
(iii)

2. Child: Nickname: Date of Birth:
Address: City: State: Zip:
Phone: Child's spouse:
Is this child of the current marriage? Yes No
If no, name of child's other parent
Child's children(and their dates of birth):
(i)
(ii)
(iii)

3. Child: Nickname: Date of Birth:
Address: City: State: Zip:
Phone: Child's spouse:
Is this child of the current marriage? Yes No
If no, name of child's other parent
Child's children(and their dates of birth):
(i)
(ii)
(iii)

4. Child: Nickname: Date of Birth:
Address: City: State: Zip:
Phone: Child's spouse:
Is this child of the current marriage? Yes No
If no, name of child's other parent
Child's children(and their dates of birth):
(i)
(ii)
(iii)

5. Child: Nickname: Date of Birth:
Address: City: State: Zip:
Phone: Child's spouse:
Is this child of the current marriage? Yes No
If no, name of child's other parent
Child's children(and their dates of birth):
(i)
(ii)
(iii)

Other Information

Is there other important personal information that might affect your estate plans? For example, does a member of your family have a serious long-term medical or physical problem that will require special care or attention in the future?