Estate Planning Questionnaire

1 Personal Information

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Client 1

First Name

Last Name

Date of Birth

Place of Birth

SSN

Cell Phone

Street Address

City

State

ZIP

Citizenship

Occupation / Employer

Client 2 (Spouse / Partner)

First Name

Last Name

Date of Birth

Place of Birth

SSN

Cell Phone

Street Address

City

State

ZIP

Citizenship

Occupation / Employer

Marital Information

Marital Status

Date of Marriage

Location of Marriage

Do you want your spouse to be the primary agent for all roles — including Guardian, Executor, Trustee, Financial Power of Attorney, and Healthcare Power of Attorney?

Yes No

Prior Marriages

Any prior marriages?

Details (spouse name, dates, obligations)

2 Children & Dependents

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Children

Other Dependents

3 Existing Documents

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Check all documents you currently have in place:

Last Will & Testament

Revocable Living Trust

Financial Power of Attorney

Healthcare Power of Attorney

Advance Directive / Living Will

Prenuptial / Postnuptial Agreement

Buy-Sell Agreement

Beneficiary Designations Reviewed

Other

Notes / details on existing documents

4 Assets

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Real Estate

Property Description / Address	Title Held As	Est. Value	Mortgage Balance

Bank & Cash Accounts

Institution	Account Type	Title/Owner	Approx. Balance

Investment & Brokerage Accounts

Institution	Account Type	Title/Owner	Approx. Value

Retirement Accounts

Institution	Type (401k, IRA, etc.)	Owner	Beneficiary	Approx. Value

Life Insurance

Company	Type (Term/Whole/Univ.)	Insured	Beneficiary	Death Benefit

Business Interests

Business Name	Entity Type	% Ownership	Est. Value

Other Significant Assets

Description	Title/Owner	Est. Value

5 Liabilities

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Creditor	Type (Mortgage, Auto, Student, etc.)	Balance Owed	Monthly Payment

6 Distribution of Estate

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Primary Beneficiaries

Contingent Beneficiaries

Specific Gifts

Gift Description	Recipient Name	Relationship

Charitable Giving

Organization Name	Amount / %	Notes

7 Guardianship

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If you have minor children, who would you like to serve as guardian?

★ Primary Guardian: Spouse (see Section 1)

Primary Guardian

Alternate Guardian

Second Alternate Guardian

Separate Financial Guardian?

Appoint a separate financial guardian?

Financial Guardian

8 Fiduciaries

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Designate individuals to serve in the following roles.

Executor / Personal Representative

★ Primary Executor: Spouse (see Section 1)

Trustee

★ Primary Trustee: Spouse (see Section 1)

Financial Power of Attorney

★ Primary Financial POA: Spouse (see Section 1)

Healthcare Power of Attorney

★ Primary Healthcare POA: Spouse (see Section 1)

9 Healthcare & End-of-Life

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Do you have specific wishes regarding life-sustaining treatment?

Organ donation preferences

Burial / cremation / memorial preferences

Any additional healthcare directives or wishes?

10 Digital Assets

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List significant digital assets, accounts, or online presence.

Account / Platform	Type (Financial, Social, Email, etc.)	Instructions / Notes

Do you use a password manager? If so, which one and how should fiduciaries access it?

11 Special Circumstances

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Are there any family members with special needs or disabilities?

Please describe

Do you expect to receive any inheritance or gifts in the future?

Please describe

Are there any family disputes or concerns that may affect your estate plan?

Please describe

Do you wish to disinherit anyone?

Please describe

Any other special circumstances or concerns?

12 Goals & Signature

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What are your primary goals for your estate plan?

Is there anything else you'd like your attorney to know?

Client 1 Signature (type full name)

Date

Client 2 Signature (type full name)

Date

Disclaimer: This questionnaire is for informational purposes to assist in the preparation of your estate plan. Completing this form does not establish an attorney-client relationship. All information provided will be kept strictly confidential. Please consult with a qualified estate planning attorney before making any legal decisions.