PRIVILEGED AND CONFIDENTIAL

WILLS & ESTATE DOCUMENT QUESTIONNAIRE
“Answers Your Volunteer Attorney Needs to Prepare Your Estate Documents”
(Short Form - updated 8/4/15)
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YOUR LAST WILL AND TESTAMENT
A Will identifies who inherits your property, who takes care of your minor children (“Guardian”), who takes care of your minor children’s property (“Guardian/Trustee”), and who administers your will (“Executor”).
Your Name: ______. Your Home Address:______
______
Marital Status: Are you married? ____. If so, what is his/her name? ______
Children: Do you have any children? _____. If so, what are their names? ______
______
Is any child less than 18 years old? ______. If so, who? ______
Your Real Property(house, land etc.): Do you own a home or property? ______. Are there other owners? ______
What is the address?______
Who should inherit your property?______
Your Personal Property (car, jewelry, collections, etc.): Do you own any valuable personal property?______
Who should inherit your valuables? ______
YourBank Accounts/Investments: Do you have any bank accounts or investments? _______
Who should inherit your accounts? _______
Your Remaining Property: Who should inherit your remaining property?______
______
Your Executor: Who should be responsible to enforce your will? ______
Guardian: Who should be responsible to care for your minor children: ______
______
Conservator/Trustee: Who should be responsible to care for your minor children’s property? ______
______
Should they be given the property at age 18? ______. If not, when? ______
Are there other conditions you wish to impose upon the property distribution? ______
Your Remains: Should you be buried or cremated? ______. Would you like a memorial service? ______
Where should the memorial service be held? ______
What should be done with your remains? ______
Disinheritance: Is there anyone whom you do not want to inherit your property? ______
Will Disputes: Is there anyone that may dispute your will? ______
Your Special Instructions: ______
______
______
______
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ADVANCE DIRECTIVE FOR HEALTHCARE
AnAdvance Directive identifies someone (“Health Care Agent”) to make your medical decisions if you cannot.
Your Health Care Agent: Who would you like this to be? ______
What is his/her cell phone number?______
Your Back-Up Health Care Agent: Who would you like this to be? ______
What is his/her cell phone number?______
Your Agents Authority: Does your Agent have authority to authorize an autopsy? ___. Donate your organs?______
Make decisions about the disposition of your remains?______
Your Agents Conditional Powers. I want my health Care Agent to make decisions for me if my doctor determines I am: 1.) in a terminal condition close to death? _____ and/or 2.) in a state of permanent unconsciousness? ______
Your Treatment Preferences: If the conditions above exist, I prefer my doctors to: 1.) allow my death to occur naturally ______, or, 2.) take reasonable steps to extend my life, or 3.) do everything possible to extend my life _____, or 4.) take the following steps: ______
______
Your Guardian: If a court thinks I need a guardian, I want my guardian to be: ______
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FINANCIAL POWER OF ATTORNEY
A POAidentifies someone (“Agent”) to manage your property and finances if you are unable to do so.
Your Financial Agent: Who would you like this to be? ______
Your Back-Up Financial Agent: Who would you like this to be? ______
Your Agents Authority: Are there any limitations or restrictions you wish to impose on your agent?______
______
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STAND-BY GUARDIANSHIP
A Standby Guardianship identifies someone (“Guardian”) to temporarily care for your minor children if you cannot.
Your Child’s Guardian: Who would you like this to be? ______
What is his/her address and contact information? ______
______
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NOMINATION OF GUARDIAN OR CONSERVATOR
A Nomination allows you to nominate someone (“Guardian or Conservator”)to be approved by the Court to act on behalf of yourself, an elderly parent or a loved one if they are unable to do so.
Ward: Who is the person needing a Guardian or Conservator? ______
Guardian/Conservator: Who should be recommended to the court? ______
What is his/her address and contact information? ______
______
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ADDITIONAL INSTRUCTIONS
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