ESTATE PLANNING INFORMATION FORM – Married Couple

Family information

Spouse 1:
Full LegalName: / Date of Birth
Preferred Name: / Place of Birth
Email / Social Security #
Occupation / Office #
Employer / Cell #
Citizenship
Spouse 2:
Full Legal Name: / Date of Birth
Preferred Name: / Place of Birth
Email / Social Security #
Occupation / Office #
Employer / Cell #
Citizenship
Home – Primary Residence
Address / Street
City/State/Zip
County / Home Phone #
Vacation Residence
Address / Street
City/State/Zip
County / Phone #
Marriage
Date of Marriage / Place of Marriage?
Previously Married? / Spouse 1: ☐ Yes/ ☐ No / Spouse 2: ☐ Yes/ ☐ No
Children of Previous Marriage / Spouse 1: ☐ Yes/ ☐ No / Spouse 2: ☐ Yes/ ☐ No
Children
Full Legal Name / Sp1/Sp2/Ours / DOB / Special Needs?
☐
☐
☐
☐
☐
☐
☐
☐
Grandchildren
Full Legal Name / Parent’s Name / DOB / Special Needs?[1]
☐
☐
☐
☐
☐
☐
☐
☐
☐
☐
☐
☐
Pets
Name / Species / Breed
Who referred you to us?

Information for your Wills and Trusts

Your wills will be structured to first give specific property or sums of money to certain beneficiaries (your “specific bequests”). For example, $10,000 to each of your nieces and nephews. Then your “residual estate” is left to certain beneficiaries. For example, the remainder of your estate to your spouse (either outright or in trust) but if your spouse is no longer living, the remainder is left in equal shares to your children or other beneficiaries to be held in trust until they reach a certain age or for their lifetimes. We will talk through all of this in detail but answering these questions now will help you start thinking through things.

Specific Bequests
To Whom / Amount or Asset Description
Charitable Bequests or Unpaid Charitable Pledges
To Whom / Amount or Asset Description
Remainder of Estate
Upon the first of you to die:
☐ Outright to Surviving Spouse?(The simplest choice)
☐ In trust for Surviving Spouse?(Provides asset protection, some tax benefits if the total estate is over ~$5M, ensures the 1st spouse to die’s assets ultimately are left to his/her beneficiaries at the 2nd spouse’s death)
☐ Some other distribution structure? (Please describe.)
Upon the second of you to die: (check all that apply)
☐ Hold in one trust until the youngest child reaches age (often age 25) then divide into separate shares for each child. (This ensures enough money is available for the youngest child to finish college.)
☐ When divided into separate shares for children, hold in trust and distribute at certain ages (For example: 1/3 at 25, 1/3 at 30, and 1/3 at 35.)
☐ Hold assets in trust for lifetime of children (This provides asset protection and keeps the assets out of the child’s taxable estate at their death. This is particularly advisable for larger estates.)
☐ Some other distribution structure? (Pleasedescribe.)
Who receives your estate if you and all your descendants die:
☐ Half to each spouse’s heirs? (this follows your family tree starting with your parents)
☐ ______% to heirs and %______to the following charities:
☐ Some other distribution structure? (Pleasedescribe.)

EXECUTOR / Trustee / Guardian

Executor[2]
Spouse 1’s Documents / Spouse 2’s Documents
Executor / ☐ Surviving Spouse
☐ / ☐ Surviving Spouse
☐
1st Successor Executor
2nd Successor Executor
Trustee[3]
Spouse 1’s Documents / Spouse 2’s Documents
Trustee / ☐ Surviving Spouse
☐ / ☐ Surviving Spouse
☐
1st Successor Trustee
2nd Successor Trustee
Guardian for Minor Children
Spouse 1’s Documents / Spouse 2’s Documents
Guardian
1st Successor Guardian
2nd Successor Guardian

Financial Power Of Attorney and HealthCare Advanced Directive

Agent Under Financial Power of Attorney[4]
Spouse 1’s Documents / Spouse 2’s Documents
Financial Agent / ☐ Spouse
☐ / ☐ Spouse
☐
1st Successor Agent
2nd Successor Agent
Healthcare Agent[5]
Spouse 1’s Documents / Spouse 2’s Documents
Healthcare Agent / ☐ Spouse
☐ / ☐ Spouse
☐
1st Successor Agent
2nd Successor Agent

Additional Qustions

Spouse 1 / Spouse 2
  1. Do you expect to inherit a substantial sum of money?
/ ☐ Yes/ ☐ No / ☐ Yes/ ☐ No
  1. Are you presently a beneficiary of any estate or trust created by someone else?
/ ☐ Yes/ ☐ No / ☐ Yes/ ☐ No
  1. Have either of you ever filed a gift tax return (IRS Form 709)? If so, please provide a copy.
/ ☐ Yes/ ☐ No / ☐ Yes/ ☐ No
  1. Is anyone other than your children dependent on you for their support?
/ ☐ Yes/ ☐ No / ☐ Yes/ ☐ No
  1. Have either of you been married previously? If so, please provide the name of your previous spouse(s), and whether the marriage ended by death or divorce.
/ ☐ Yes/ ☐ No
Name:______
☐ Death/ ☐ Divorce / ☐ Yes/ ☐ No
Name:______
☐ Death/ ☐ Divorce_
  1. Do you have a continuing obligation from a previous marriage? If so, please provide a copy of your settlement agreement.
/ ☐ Yes/ ☐ No / ☐ Yes/ ☐ No
  1. Have you executed a pre-nuptial or post-nuptial agreement regarding your marriage? If so, please provide a copy.
/ ☐ Yes/ ☐ No / ☐ Yes/ ☐ No
  1. Have you lived in a community property state (Arizona, California, Idaho, Louisiana, Nevada, New Mexico, Texas, or Washington) during your marriage?
/ ☐ Yes/ ☐ No / ☐ Yes/ ☐ No
  1. Do you have any personal loans payable to you?
/ ☐ Yes/ ☐ No / ☐ Yes/ ☐ No
  1. Are you a party to any lawsuit, judgment, or other claim against you, or is any threatened?
/ ☐ Yes/ ☐ No / ☐ Yes/ ☐ No
  1. Are you a personal guarantor of any debt of another person or entity?
/ ☐ Yes/ ☐ No / ☐ Yes/ ☐ No
  1. Do you own any interest in any real estate located outside the State of Georgia? If so, where?
/ ☐ Yes/ ☐ No / ☐ Yes/ ☐ No
  1. Any family owned entities (LLC, Partnership, or corporation)?
/ ☐ Yes/ ☐ No / ☐ Yes/ ☐ No
  1. Are you concerned about "avoiding probate"?
/ ☐ Yes/ ☐ No / ☐ Yes/ ☐ No
  1. Do you want to make plans for the care of a pet?
/ ☐ Yes/ ☐ No / ☐ Yes/ ☐ No

Additional Questions(cont.)

Do you have:Please list the name of:

Long Term Care Insurance / ☐ Yes/ ☐ No / CPA/tax advisor
College Funding / ☐ Yes/ ☐ No / Financial advisor
Health Insurance / ☐ Yes/ ☐ No / Life Insurance agent
Retirement Accounts / ☐ Yes/ ☐ No / Bank
Life Insurance / ☐ Yes/ ☐ No
A safety deposit box?
Location: ______/ ☐ Yes/ ☐ No

Additional information

USE ADDITIONAL PAPER IF NECESSARY

Asset Inventory

It is important for us to know what assets we need to plan for passing at the time of your death. We need to know what the asset is, it’s approximate value, and whose name it is in. Please list the approximate value in the appropriate column for each of your assets and liabilities and then provide a total at the bottom.

FAIR MARKET VALUE
Spouse 2 / Spouse 1 / Joint
ASSETS / $ / $ / $
REAL ESTATE / $ / $ / $
Primary Residence / $ / $ / $
Other Real Estate: / $ / $ / $
$ / $ / $
$ / $ / $
RETIREMENT FUNDS(IRA/Pensions/401(k)) / $ / $ / $
IRA accounts / $ / $ / $
$ / $ / $
$ / $ / $
$ / $ / $
DEPOSIT ACCOUNTS (Cash) / $ / $ / $
$ / $ / $
$ / $ / $
STOCKS-BONDS-MUTUAL FUNDS-STOCK OPTIONS / $ / $ / $
$ / $ / $
$ / $ / $
$ / $ / $
CLOSELY HELD BUSINESSES / $ / $ / $
$ / $ / $
$ / $ / $
LIFE INSURANCE - (death benefits) Please also list beneficiaries. / $ / $ / $
Insuring Spouse 1: / $ / $ / $
$ / $ / $
$ / $ / $
Insuring Spouse 2: / $ / $ / $
$ / $ / $
$ / $ / $
AMOUNTS OWED TO YOU BY OTHERS / $ / $ / $
$ / $ / $
OTHER ASSETS / $ / $ / $
$ / $ / $
$ / $ / $
LIABILITIES / $ / $ / $
Mortgage - primary residence / $ / $ / $
Mortgages - other real estate / $ / $ / $
Personal Loans / $ / $ / $
Other / $ / $ / $
Net Worth = / $ / $ / $

DOCUMENTATION NEEDED

Please bring the following documents with you to our meeting. If you have additional documents that you think are relevant, please bring those with you as well. Without these documents in front of us, there may be unanswered questions at the end our initial meeting. Unanswered questions can draw out the estate planning process and therefore make it more expensive for you. Please help us keep your fees down by having these documents available at our initial meeting.

☐ / Current Will
☐ / Pre-nuptial or post-nuptial agreement
☐ / Divorce Settlement Agreement
☐ / Copy of Deed(s) to any property you own
☐ / Copies of any trusts you created
☐ / Copies of any filed Gift Tax Returns (IRS Form 709)
☐ / Copies of any trusts where you are the beneficiary
☐ / Other material that you think may be relevant to your estate plan

[1]Special needs might include physical or psychological difficulties, particular lack of maturity, learning disabilities, financial problems, or marital difficulties

[2]You may name individuals (family members, friends, professional advisors, etc.) or bank trust departments. You may also name Co-Executors to serve together, such as a family member and a bank or professional.

[3]You may name individuals (family members, friends, professional advisors, etc.) or bank trust departments. You may also name Co-Trustees to serve together, such as a family member and a bank or professional.

[4]You may name one or more individuals to serve together to act for you in financial matters.

[5]You may name one or more individuals to serve together to make any healthcare decisions for you if you are unable to make them yourself.