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ESTATE-PLANNING QUESTIONNAIRE OF KING LEGAL GROUP, S.C.

If you wish to have a free analysis and price consultation for your estate-planning needs, please:

1. Download the PDF version of this questionnaire. 
       or
2. Download the Microsoft® Word® version of this questionnaire.
       or
3. Copy and paste the questionnaire found below into an email and forward it to us. 

PDF VERSION


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WORD® DOCUMENT


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1. FAMILY BACKGROUND                            Date Prepared:

HUSBAND                                 WIFE

Name:                 __________________            __________________

Date of Birth:       __________________            __________________

Employment:        __________________           __________________

Soc. Sec. No.:       __________________           __________________

U.S. Citizen:                  Yes/No                                 Yes/No

Prior Marriage:               Yes/No                                 Yes/No

Children by:                   Yes/No                                 Yes/No

Prior Marriage:               Yes/No                                 Yes/No

Address:   ____________________________________________________________________

Home Phone:   ______________          Business Phone:   ______________

Date of Marriage:   ______________          Date of Wisconsin Residency:   __________

Child of

CHILDREN        AGE                      ANOTHER MARRIAGE MARRIED

1. Yes/No     Yes/No

2. Yes/No     Yes/No

3. Yes/No     Yes/No

4. Yes/No     Yes/No

On a separate sheet (to be attached to this questionnaire), please list the names of any additional children.

GRANDCHILDREN             AGE                      RELATED PARENT MARRIED

1. ____ YES/NO

2. ____ YES/NO

3. ____ YES/NO

4. ____ YES/NO

Please list any additional grandchildren on a separate sheet to be attached to this questionnaire.

GREAT GRANDCHILDREN:  YES/NO

ANY ISSUE SUFFER FROM DISABILITIES:  YES/NO

2. FIDUCIARIES Please indicate who you would like to serve as the following:

(a) PERSONAL REPRESENTATIVES – This is the person who acts as the executor of your estate. Their duties and responsibilities entail making sure that your wishes and desires as listed in your will are carried out.

HUSBAND

Personal Representative:

Address:

Alternate #1:

Address:

Alternate #2 (optional):

Address:

WIFE:

Personal Representative:

Address:

Alternate #1:

Address:

Alternate #2 (optional):

Address:

(b) TRUSTEE – If your estate plan will include a trust, this person’s or entity’s duties and responsibilities will be to ensure that the terms of the trust document are carried out.

Name:

Address:

Alternate #1:

Address:

Alternate #2 (optional):

Address:

Corp. Trustee:

Address:

(c) TRUST DISTRIBUTIONS:

Outright at Certain Age:

Specific Time Line:

(for example, 1/3 at age 21, 1/3 at age 28, 1/3 at age 30):

(d) GUARDIANS FOR MINOR CHILDREN:

Name:

Address:

Alternate #1:

Address:

Alternate #2 (Optional):

Address:

(e) DURABLE POWER OF ATTORNEY – This is the person you are appointing with the power to make your financial decisions in the event that you are unable to do so.

HUSBAND

Name:
Address:
Soc. Sec. No.:
Co-attorney (Optional):
Address:
Soc. Sec. No.:

WIFE 

Name:
Address:
Soc. Sec. No.:
Co-attorney (Optional):
Address:
Soc. Sec. No.:

(f) HEALTH CARE POWER OF ATTORNEY – This is the person you are appointing with the power to make your healthcare decisions in the event that you are unable to do so.

HUSBAND

Name:

Address:
Phone No.:

Alternate #1
Address:
Phone No.:

Alternate #2 (Optional)
Address:
Phone No.:

WIFE

Name
Address
Phone No.

Alternate #1
Address
Phone No.

Alternate #2 (Optional)
Address
Phone No.

This document will also address the following situations that you will need to address in the document. If you are unsure as to how you would answer this question or need to discuss this further, please leave this blank.

If you are terminally ill or in a comatose-like state (that is, a vegetative state) and are not expected to recover as confirmed by at least two physicians, is it your desire to have your life prolonged with life support systems and feeding tubes?

Husband _____________ (yes or no)     Wife ________________ (yes or no)

3. ESTATE-PLANNING INFORMATION 

Wills YES/NO Bring copies

Trusts YES/NO Bring copies

Marital Agreement YES/NO Bring copies

Power of Attorney YES/NO Bring copies

Living Wills YES/NO Bring copies

Gift-Tax Returns YES/NO Bring copies

Power of Apt.

under any

trust or other

instrument Husband YES/NO     Wife YES/NO

Expected

inheritance Husband YES/NO $     Wife YES/NO $

4. ASSETS (Indicate if any assets are jointly owned with another person.)

HUSBAND’S     WIFE’S JOINTLY

SOLE NAME R* SOLE NAME R* OWNED R*

(a) Investments (R*= Interest Rate)

1. Cash or equivalent

(for example, savings, CD)

2. Stocks and Bonds

(b) Real Estate 

(Indicate if out of state.)

1. Residence _________ __________ ________

Mortgage ( ) ( ) ( )

2. Vacation Home _________ __________ ________

Mortgage ( ) ( ) ( )

3. Investment _________ __________ ________

Property Mortgage ( ) ( ) ( )

(c) Business Interest 

1.

2.

3.

HUSBAND’S     WIFE’S     JOINTLY

SOLE NAME R*     SOLE NAME R*     OWNED R*

(d) Personal Property 

1. Auto/Boat

2. Home furnishing

3. Other (Identify)

a.

b.

(e) Other Assets

1.

2.

3.

4.

(f) Employee Benefits 

1.

2.

3.

4.

(g) Life Insurance (Non-Business) 

Face Policy

Company: Policy No.     Value      Loans     Owner     Insured     Beneficiary

1.

2.

3.

H. Husband’s Trust Interest

Wife’s Trust Interest

5. DEBTS OTHER THAN LOANS AND MORTGAGES LISTED ABOVE 

HUSBAND’S     WIFE’S     JOINTLY

SOLE NAME     SOLE NAME     OWNED

(a)

(b)

(c)

(d)

(e)

6. INCOME 

HUSBAND WIFE

Salary/Wages

Other

Description of other income:

7. PRIOR TAXABLE GIFTS (that is, gifts of more than $13,000 annual amount per individual or $26,000 annual amount for married couples)

Date     Donor     Recipient     Amount

8. MISCELLANEOUS

Safe Deposit box YES/NO Location

Accountant   YES/NO   Name & Phone No.         Broker   YES/NO   Name & Phone No.
Life Insurance Agent   YES/NO   Name & Phone No.       Banking relationship   YES/NO   Name

OTHER UNIQUE FACTS OR CIRCUMSTANCES TO BE CONSIDERED: