Blog

Estate Planning Questionnaire

I have pasted below a standard estate planning questionnaire. I would be happy to email you an easier version to work with. Just send me an email and ask!  I can send in Word or PDF as you prefer.  -John

PRIVATE AND CONFIDENTIAL

ESTATE   PLANNING  

FACT GATHERING 

PACKAGE

 

LAW OFFICE OF

MEISSNER, JOSEPH & PALLEY, InC

JOHN B. PALLEY

Attorney at Law

Meissner,  Joseph & Palley, INC.

1555 River Park Drive, Suite 108

Sacramento, CA 95815

916-920-5983 Phone

916-920-9379 Fax

2200 Douglas Blvd, Suite 150B

Roseville, CA 95661

 

PRIVATE AND CONFIDENTIAL

Before we begin the estate planning process, let us start by thanking you for selecting Johnson, Fort, Meissner, Joseph & Palley to prepare your estate planning documents.  Even the most basic estate planning, to be effective, requires the attorney to analyze a lot of personal information.   This includes information concerning your personal, family and financial status.   We have prepared this form to aid you in organizing that information.  However, do not think that this has to be completely filled out; this is not a test.  This form is intended to get you thinking about the important issues related to estate planning. 

 

When you come into our office we will discuss all of this and more, in a face-to-face manner.  Please take your time filling this out, but do not procrastinate and put this at the bottom of the pile of things to do.  This is important, easy to do, and relatively painless.  

 

Also, please remember that you are not protected by an estate plan until the FINAL DRAFT IS COMPLETED, SIGNED, WITNESSED, AND NOTARIZED. 

 

Once again, thank you for selecting Johnson, Fort, Meissner, Joseph & Palley to assist you with preparing your estate plan.     

 

 

 

NOTICE OF  CONFIDENTIALITY:   AS IS TRUE WITH MOST COMMUNICATIONS BETWEEN LAWYER AND CLIENT, THE INFORMATION REPORTED HERE WILL BE HELD IN THE STRICTEST CONFIDENCE AND RELEASED TO NO ONE WITHOUT YOUR CONSENT.

FULLY CANDID ANSWERS ARE ESSENTIAL FOR COMPLETING THE ESTATE PLANNING PROCESS.

 

 

FINANCIAL INFORMATION

The Starting point of the estate planning process requires you to roughly calculate the size and nature of your estate assets.  Please specify in the margin if the asset is “community property” (acquired during marriage) or “separate property” (acquired before marriage or inherited during marriage).

 

0)     INCOME

Total Annual Income of Household                                        $ _____________

_________________________________________________

1)      CASH AND SAVINGS (Please supply bank name, address and account number)

Checking Account                   $ ___________

Certificates of Deposit (CDs)  $ ___________

Credit Union                            $ ___________

Savings Account                      $ ___________

Money Market                         $ ___________

TOTAL CASH AND SAVINGS                                $ ______________

 

2)     MARKETABLE SECURITIES (Please include bank name, address and account number)

Stocks                                      $ ___________

Bonds                                      $ ___________

Mutual Funds                          $ ___________

Annuities                                 $ ___________

Gold and Silver                       $ ___________

TOTAL OF MARKET SECURITIES                       $ ______________

 

3)     REAL ESTATE  (Please list address, city and state)

TYPE OF PROPERTY   COUNTY            MARKET VALUE –  MORTGAGE = EQUITY

 

i.   _______________________________           ______________________________________

ii.  _______________________________           ______________________________________

iii. _______________________________           ______________________________________

TOTAL EQUITY IN REAL ESTATE                      $ _______________

 

 

 

 

 

 

4)     FIXED AND OTHER ASSETS (Please supply additional information if available)

 

Business Interests                    $ ___________

Limited Partnerships               $ ___________

Notes Due                               $ ___________

TOTAL OF FIXED AND OTHER                           $ ________________

 

5)     RETIREMENT PLANS (Please bring bank name, address and account number)

 

IRA (Standard Deductible)      $ ___________

IRA (Roth IRA)                       $ ___________

Keogh                                      $ ___________

SEP                                         $ ___________

401k                                        $ ___________

403B                                        $ ___________

Profit Sharing Plan                  $ ___________

TSA                                         $ ___________

ESOP                                      $ ___________

PASOP                                    $ ___________

Deferred Compensation          $ ___________

Pension Plan                            $ ___________

TOTAL OF RETIREMENT PLANS                        $ ________________

 

6)     LIFE INSURANCE (Please list life insurance company and agent, if you know)

 

Face Value of Policy #1          $ ___________  (Term  or   Whole Life?)

Face Value of Policy #2          $ ___________  (Term  or   Whole Life?)

Face Value of Policy #3          $ ___________  (Term  or   Whole Life?)

 

TOTAL FACE AMOUNT OF LIFE INSURANCE  $ ________________

 

7)      OTHER ASSETS (Cars, boats, collectibles, etc.)

$ ___________

$ ___________

TOTAL OF OTHER ASSETS                      $ ________________

 

 

 

GRAND TOTAL OF ALL ASSETS                        $ ________________

 

The “will” is the foundation of any estate plan.  No matter what size your estate is, a will is the backbone of that estate plan.

 

 

  1. 1.      Your Preliminary Information (For ALL Estate Planning Clients to Fill out)

 

Your Full Name:  _____________________________ Your Social Security: ______________

Your Date of Birth: ____________

Spouse’s Name:  ___________________________ Spouse’s Social Security: ______________

Spouse’s Date of Birth: ____________

Address:          __________________________________________________________________

Phone(s):         (H) __________________; (W) _________________(Other) _______________

CountyofResidence: ____________________

Country of Citizenship:   You ____________________ Spouse ___________________

 

What state were you legally married in: _______________

Include Other Names You have used: _________________________________________

Indicate Maiden Name, if applicable: ___________________

 

Past Marriages:

Name of Former Spouse:  (1) _________________________(2) ___________________

Ended by Death or Divorce:  (1) _____________________ (2) ____________________

Pre-Nuptial Agreement?  Yes___     No___  (If yes, please attach copy)

 

 

 

2. NAMES AND PHONE NUMBERS OF YOUR FINANCIAL ADVISORS

Accountant: ________________________________________

Insurance Agent: ____________________________________

Stockbroker: ________________________________________

Realtor: ____________________________________________

Other: _____________________________________________

 

 

 

3. Burial Requests and Organ Donation

Do you have any special requests for burial (i.e. cremation or burial)?

Husband: __________________________________________

Wife: _____________________________________________

Do you want to be an organ donor?  Yes ___    No ____                   Yes ___    No ____

HUSBAND                             WIFE

 

Special Requests: _______________________________________________________________

 

 

 

 

4.  Children (please indicate if child is deceased, adopted, step child, if from a prior

                         marriage, and if child is handicapped)

Name:                                              DOB:           Where born:

i)____________________________    ________   _______________

ii)____________________________   ________   _______________

iii)____________________________  ________   _______________

iv)____________________________   ________   _______________

Who do you want to have Custody of your Children?  This is also known as the “Guardian”.  Include alternate choices please.  Although husband and wives are ok, please remember the possibility of death or divorce.

NAME                                      CITY THEY RESIDE IN

i)       ______________________              ___________________

ii)      ______________________              ___________________

iii)     ______________________              ___________________

iv)      ______________________              ___________________

 

 

 

5. Beneficiary Selection

With the exception of establishing a guardian for any underage children, the beneficiary selection is the most crucial aspect of your estate plan.  This is where you determine who gets what and how much they get.   Although you should take extra time reading through this section, you will likely want to discuss these issues with me in a face to face meeting.  Do your best, but don’t feel that everything has to be filled out completely.

 

You may want to begin by jotting down some general thoughts about who you want to get your property.  The questions can help make these determinations more concrete.  Consider if you die first and if your spouse dies first.

 

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

 

 

 

 

PERSONAL PROPERTY-General Gifts.   Generally speaking, who do you want the bulk of your personal property (non-monetary or real property assets) such as paintings, collections, furniture, etc. to go to?  You have the opportunity in the next question to leave specific items to other people.  Feel free to have multiple people (i.e. all living children at your death) to share your personal property.

First Choice: _______________________________________________________________

Second Choice: _____________________________________________________________

Third Choice: ______________________________________________________________

Fourth Choice: _____________________________________________________________

PERSONAL PROPERTY- Specific Gifts.   If you would like to make specific gifts of personal property, such as art, collectibles, etc., please list the items below and the recipients (with at least one successor person named, in case your first choice person is unable to take the gift).  You can not list everything you own in a simple will; it is just not practical.  The following items should be pieces of personal property that do not follow the general flow of your personal property (for example, maybe you want your special painting to go to your best friend rather than a spouse or child).

ITEM                                                  First Choice                             Second Choice

1) ___________________________________________________________________________

2) ___________________________________________________________________________

3) ___________________________________________________________________________

4) ___________________________________________________________________________

5) ___________________________________________________________________________

 

BULK OF PROPERTY.   Who do you want to receive the bulk of your assets (money, real property, stocks, bonds, etc.) when you pass away?  Feel free to divide up your estate in percentages (for example 30% to child 1, 30% to child 2, 30% to child 3, and 10% to your favorite niece).  List back up choices; that is, if your primary beneficiaries are not alive who would you want to inherit your property?  A person? A charity?  If unsure, just jot down general notes.

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

______________________________________________________________________________

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

 

Small gifts of Cash.  In addition to the general flow of all your assets, is there anybody you would like to give a small cash gift to upon your death (i.e. $500 to a special niece or nephew)?

1) _____________________________________

2) _____________________________________

3) _____________________________________

 

Charitable Gifts.  Would you like to make any charitable contributions (which are tax deductible) upon your death?  (Religious organizations, schools, fraternal organizations, and other such groups)

1) _____________________________________

2) _____________________________________

3) _____________________________________

 

Disinheritance.  Is there anybody you would like to specifically not give assets to at death?

1)      ____________________________  2) _______________________________

 

Trust Gifts.  If we are establishing a trust for minor children, at what age(s) would you like disbursement to be made to the children without the trust restrictions?  __________

 

6.  Trustees

If you are setting up a trust for you, and you are unable to serve as trustee and administer the affairs of the trust, who do you want to serve in the roll of trustee?

 

1) _____________________________________

2) _____________________________________

3) _____________________________________

4) _____________________________________

Can be the same as executor chosen below….

 

 

If unsure about the advantages and disadvantages of a trust, make sure we discuss it.

Also, if we are setting up a trust for you, we will talk in-depth about how they work, both before death and after death; so you fully understand what you are doing.

 

7. Executors

Who would you like to be Executor (or Personal Representative) of your will and estate upon your death?  Their responsibility will be to distribute all of your personal property to the appropriate people and make sure the monetary assets either get to the people mentioned, or if you are also setting up a trust, that the assets get transferred to the trustee. Can choose the same people or you each can choose different people.

 

1) _____________________________________

2) _____________________________________

3) _____________________________________

4) _____________________________________

5) _____________________________________

 

8. Other Inheritance Questions

1) Are you or your spouse beneficiaries or trustees of any trust?                     Yes     No

2) Do you or your spouse have a power of appointment under any trust?       Yes     No

3) Do you or your spouse anticipate receiving an inheritance?                                    Yes     No

4) Have you ever filed (or had filed on your behalf) a gift tax return?             Yes     No

If yes to number 4, please bring copies.

5) Have interest in sole proprietorship, general partnership, limited

partnership or any closely held business?                                            Yes     No

6) Have you made gifts of over $10,000 to anybody in any year?                   Yes     No

 

9. Do you have any special requests for your pets upon death?

 

 

Who To Take Care of them?

1) ______________________

2) ______________________

 

Any Money to go to caretakers? __________________________

 

 

OTHER ESTATE PLANNING DOCUMENTS

(Not optional, these are the ancillary documents necessary to complete an estate plan!)

 

  1. 10.     Durable Power of Attorney for Financial Affairs

This document gives someone the power to make all sorts of financial decisions for you.   These include, but are not limited to the following:

*                     Most all financial affairs

*                      Investments

*                      Make Gifts

*                      Pay mortgage and other bills

*                      Conduct Banking

*                      Deal with Insurance

*                      Make Loans

*                      Operate Business

*                      Personal Care (Where you live, meals, take care of pets, handle mail, provide transportation, etc.)

 

This power will spring into effect when you are unable to handle your own affairs, as determined by a vote of 2 out of 3 named people in the document.

 

You should indicate your first choice, and successor choices, to hold your power of attorney.  You can choose the same or choose different people:

1) _____________________________________

2) _____________________________________

3) _____________________________________

4) _____________________________________

 

 

 

  1. 11.      Durable Power of Attorney for Health Care (“Living Will”)

This document is similar to the above, but allows someone to make health care related decisions for you.  The powers are extensive, and include the ability to:

  • Consent or refuse medical care
  • Employ and Discharge Doctors
  • Consent to or refuse life prolonging procedures
  • Protect Right of Privacy
  • Prevent pain
  • Provide for companionship

 

This document is also called a “Living Will.”  It tells the doctors what you want (or don’t want) in the way of life support.  This means an incurable and irreversible condition that has been diagnosed by two physicians and:

– Will result in death within a relatively short time without administration of life-                                         sustaining treatment; or

– Has produced an irreversible coma; or

– Persistent vegetative state.

 

Generally, I prepare the documents in a similar manner for most everybody.  However, we can alter it for your needs if you desire something different.  Generally, life support that is cut, if you are no longer able to make decisions regarding medical treatment, include:

– Food and water by artificial administration, even if would prolong life;

– Comfort care, even if would prolong life;

– All additional life-prolonging treatment be withheld, except for:

-Blood and blood products;

– Cardio-pulmonary resuscitation (CPR);

– Diagnostic tests;

– Dialysis;

– Drugs;

– Respirator;

– Surgery

 

 

Please initial here if you are in agreement with this ____________                ______________

Wife                             Husband

You should indicate your first choice, and successor choices, to be your health care Agent. Can choose the same or different people:

 

1) _____________________________________

2) _____________________________________

3) _____________________________________

 

 

 

 

 

 

 

 

13. Other Thoughts you have about your estate plan?  ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

 

Thank you for taking the time to fill out this questionnaire. Please call us immediately to set up an appointment to discuss your answers and prepare your documents. 

 

DIRECTIONS TO

JOHNSON, FORT, MEISSNER, JOSEPH & PALLEY

1555 River Park Drive, Suite 108

Sacramento, CA 95815

(916) 920-5983

 

BAY AREA/DOWNTOWN SACRAMENTO: 

I -80 East Bound towards Reno.  However, take the Business 80 transition when you get to Sacramento.  Do not take I-80 towards RENO.  Once on Business 80, exit at Arden Way. Stay in the right lane until you get to Point West. (Double Tree Hotel on right hand corner).  Turn right at Point West (Elephant Bar Restaurant on corner). Take Point West to Response. Make a right turn on Response to River Park Drive.  Turn right on River Park Drive.

 

 

ROSEVILLE/AUBURN AREA:

I-80 W/B to Business 80 (CapitalCityFwy). Take the Capital City Fwy to theArdenexit.  Stay in the middle turn lane.  At the light, turn ontoArden Way. After you go under the Fwy, merge to far right lane.  (Double Tree on right hand corner). Turn right at Point West (Elephant Bar Restaurant on corner). Take Point West to Response. Make a right turn on Response toRiver Park Drive.  Turn right onRiver Park Drive.

 

RANCHO CORDOVA/EL DORADO HILLS:

Hwy 50 to theHowe Avenueexit.  Make a right turn on Howe and take it toArden Way(several miles).  Make a left turn atArden Way.  TakeArdentoHeritage Lane.  Make a left turn onto Heritage.  Take Heritage to Response.  Make a right turn on Response toRiver Park Drive.  Turn right onRiver Park Drive.

 

LAW OFFICE OF

JOHNSON, FORT, MEISSNER, JOSEPH & PALLEY

FOR ATTORNEY TO FILL OUT

 

Referred By: _________________________________  Thank You Note Sent:  _____

 

Written Fee Agreement Necessary? __________

            Fee Range: $ __________

 

Conflict issue Discussed? __________

            Letter Necessary? _________  Sent?  ____ When: ___________

 

Appointment for Execution of Documents: ___________________________

            Where:  My Office    Elsewhere ______________________

 

 

 

Documents to Prepare:

 

Will ____

            With Trust for kids _____

            With Tax clause ____

            With Guardianship _____

            Pour Over _____

            Simple _____

 

Trust ____

            Single _____

            Two _____

            Three _____

 

Durable Power of Attorney for Financial ____ 

 

Health Care Declaration (Living Will) _____

 

Advanced Trusts Necessary ______

            ILIT    ______

            CRT    ______

            FLP     ______

            GRIT ______

 

Other: