ESTATE PLANNING QUESTIONNAIRE (Copyright 1998)   

Name __________________________

Spouse's name____________________                                                                     

Address __________________________________________

Names/ages of children__________________________________   

Own ____ Rent ____

Home equity (market value less debt) __________________

Other real estate: description/value/equity _______________________

Life insurance: name of insurer ________________________ 

Policy no.  _________________  term ____   whole life ___                           

 Beneficiar(ies) _______________________________________      

Other assets (description and value):

   Automobiles ___________________________

   Bank accounts __________________________             

   Stocks________________________________

   Bonds ________________________________

   Jewelry _______________________________

   Other _________________________________

Name/relation of executor __________________

Name/relation of guardian __________________

Name/relation of trustee ____________________

I want a ___ simple will ___will with trust ___living will

other ____________________________________