ESTATE PLANNING CHECKLIST - PAGE 2
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Personal and Family Financial Assets

The following questions do not require detailed responses. For example, shares in publicly traded companies might be shown simply as "common stocks." On the other hand, for property interests that are more or less unique, such as interests in real estate, greater detail will be helpful. With regard to real estate, it is important for this office to know the location (city and state) of the real estate, how title is held, and the character of the property, e.g., commercial or residential.

The following abbreviations may be used to describe certain attributes of particular assets:
JT = Joint tenancy with right of survivorship
TC = Tenancy in common
H = Husband's name alone
W = Wife's name alone
LT = Land trust
FMV = Fair market value (or your best guess)
CV = Cash value of life insurance policy
PV = Proceeds of life insurance policy

Real Estate

1. Personal residence
Address:
Description (e.g., single family, condo, or similar description):
How do you hold title:
FMV: Mortgage Balance, if any:
Mortgage life insurance?
Date of occupancy: or intended occupancy:

2. Other personal residences or vacation homes:
Address:
Description (e.g., single family, condo, or similar description):
How do you hold title:
FMV: Mortgage Balance, if any:
Mortgage life insurance?
Date of occupancy: or intended occupancy:

3. Other investment real property:
Address:
Description (e.g., single family, condo, or similar description):
How do you hold title:
FMV: Mortgage Balance, if any:
Mortgage life insurance?
Date of occupancy: or intended occupancy:

Personal and Household Effects:

If you think that the general categories do not provide an adequate description, please provide additional detail. Also, state your best estimate of the value of each kind of property and who owns it (how you hold title).

Automobiles:
Year Make Model Value
Year Make Model Value
Year Make Model Value

Approximate value of general personal and household effects such as furniture, furnishings, books, and pictures of no special value:

Valuable jewelry (indicate if insured):
Valuable works of art (indicate if insured):
Valuable antiques:
Other valuable collections, e.g., coins, stamps or gold:
Other tangible personal property that does not seem to be covered by any of the other categories:

Closely held business interests.

Describe any interest you have in a family or other business with limited shareholders. Include the nature of the business, its form of organization (e.g., sole proprietorship, partnership, limited liability company, "C" corporation, "S" corporation, etc.), whether you are active in its operations, and your estimate of its value. If it is a corporation, please indicate whether an "S election" is in force with respect to the corporation.

Name of business: Form of organization:
Type of business (eg: manufacturing, service, etc.)
Address and phone number
Which spouse is active in the business?
Husband: In what capacity?
Wife: In what capacity?
Current fair market value of the business:
Estimated fair market value if Husband dies or becomes disabled:
Estimated fair market value if Wife dies or becomes disabled:

Please bring all relevant documents, including partnership agreements, articles of incorporation, by-laws, buy-sell agreements, etc., to your initial interview.

Cash, cash deposits, and cash equivalents. Who owns item?

(a) Personal Checking accounts (Do not report business accounts here)

Name of financial institution: Branch:
Account number: Balance:

Name of financial institution: Branch:
Account number: Balance:

Name of financial institution: Branch:
Account number: Balance:

(b) Money Market accounts

Name of financial institution: Branch:
Account number: Balance:

Name of financial institution: Branch:
Account number: Balance:

Name of financial institution: Branch:
Account number: Balance:

(c) Ordinary savings accounts

Name of financial institution: Branch:
Account number: Balance:

Name of financial institution: Branch:
Account number: Balance:

Name of financial institution: Branch:
Account number: Balance:

(d) Certificates of deposit

Name of financial institution: Branch:
Account number: Balance:

Name of financial institution: Branch:
Account number: Balance:

Name of financial institution: Branch:
Account number: Balance:

(e) Non-Retirement Investment Accounts (Indicate retirement accounts below)

Name of brokerage firm: Broker:
Account number: Balance:

Name of brokerage firm: Broker:
Account number: Balance:

Name of brokerage firm: Broker:
Account number: Balance:

Please bring statements of accounts, passbooks, and certificates of deposit to initial interview.

Pension and profit-sharing plans, ESOPs, SEPs, etc.

(a) Pension plans.

Name, address and phone number of Employer:
Employee: Type of Plan: Date vested: Value:
Name, address and phone number of administrator:

Name, address and phone number of Employer:
Employee: Type of Plan: Date vested: Value:
Name, address and phone number of administrator:

(b) Profit-sharing plans.

Name, address and phone number of Employer:
Employee: Type of Plan: Date vested: Value:
Name, address and phone number of administrator:

Name, address and phone number of Employer:
Employee: Type of Plan: Date vested: Value:
Name, address and phone number of administrator:

(c) Individual Retirement Accounts (IRAs).

Name of financial institution: Branch:
Account number: Balance:

Name of financial institution: Branch:
Account number: Balance:

Name of financial institution: Branch:
Account number: Balance:

Name of financial institution: Branch:
Account number: Balance:

(d) Other tax-qualified employee benefit plan interests. Please provide pertinent information.

Please bring current statements and other materials to your initial interview.