Estate Planning Questionnaire

Husband

Date of Birth

Wife

Date of Birth

(Date of birth only required if under 18)

Children

Date of Birth

Other Persons Named in Estate Plan

Date of Birth

Have you ever been divorced? If so, approximate date of divorce decree:

(a) Approximate value of estate:
(b) General description of assets (e.g., real and personal property, business interests,
investments, retirement, etc.)

We’ll cover the rest during our conversation. Thanks!

9+3=?

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