Estate_Planning_Questionaire__[Estate_Plan_Que.doc

此文档收集于网络，如有侵权，请联系网站删除Diane L. Rivers Attorney At LawAdmitted in NY, NJ and CTCPA, LL.M. in taxation185 East 85th Street, Suite 3K“Of Counsel” to the New York, New York, 10028-2172Bohonnon Law Firm, LLCTelephone: (212) 722-4084205 Church Street, Suite 506Fax: (212) 831-3218New Haven, Connecticut 06510Web site: http:/www.DianeRE-mail: DianeDianeRCONFIDENTIAL ESTATE PLANNING QUESTIONNAIREThis Confidential Estate Planning Questionnaire should be returned in advance of our initial estate planning meeting. All information will be kept confidential. This information is necessary to begin the estate planning process. The more detail the better. Add extra pages as needed. Please print clearly all names and addresses so that they can be properly included in any documents. The more complete and accurate this Questionnaire is, the more efficient our initial meeting will be. If you have any questions while filling out this Questionnaire, please call or just note them below for discussion at our meeting. I look forward to working with you.I. Goals.Please explain what you would like to accomplish with your estate plan. Briefly state your objective or concerns. _II. Background Information.Topic/ItemYourselfYour Spouse/PartnerName to be used on your estate planning documents_Other names (e.g., nickname, maiden name or other aliases)_Home: Street address (including City/State/Zip Code)_County of residence_Home: Fax number_Home: Telephone number_Business: Occupation/Description (please indicate if sole proprietorship, closely held corporation, LLC, LLP, partnership, etc.)_Business: Street Address (including City/State/Zip Code) _Business: Telephone number_Business: Fax number_E-mail address_Date of birth/Place of birth/age_Social Security Number_Citizenship_III. Community Property.Have either of you ever lived in Arizona, California, Idaho, Louisiana, Nevada, New Mexico, Texas or the State of Washington? If yes, please provide dates and please indicate if you were married during any of these periods. If you were married, please provide information regarding your estate at the time of marriage in such state, the place of marriage, assets acquired during marriage, your domicile at the time of the acquisitions, the source of funds used for such acquisitions and the value of any gifts or inheritances received by you during the marriage:_IV. Marital Information.Topic/ItemYourselfYour Spouse/PartnerCurrent Marital status:Single Married Widowed Divorced Separated Single Married Widowed Divorced Separated Current Marriage: Spouse Name_Current Marriage: Date and Place of Marriage_Current Marriage:Please provide a copy of the applicable agreements listed. Prenuptial Agreement Postnuptial Agreement Other. Please explain._ Prenuptial Agreement Postnuptial Agreement Other. Please explain._Prior Marriage(s): Spouse Name1._2._3._1._2._3._Prior Marriage(s): Date and Place of Marriage1._2._3._1._2._3._Prior Marriage(s): Date and reason of termination.1._2._3._1._2._3._Prior Marriage:Please provide a copy of the applicable agreements. Prenuptial Agreement Postnuptial Agreement Separation Agreement Divorce Agreement Other. Please explain. Prenuptial Agreement Postnuptial Agreement Separation Agreement Divorce Agreement Other. Please explain.V. Information on Your Parents.Topic/ItemYour MotherYour FatherName:_IF LIVING:Age:Age:Street Address (including City/State/Zip Code)_Telephone number_Description of financial status_How parents estate plan relates to you._Anticipated inheritance_Anticipated financial responsibility_Are you agent/executor etc.? Please describe._IF NOT LIVING:Date of death_Status of probate. Please attach copy of estate tax return._Any trusts or other planning affecting you.Please attach copy._If you have a step parent or adopted parents, please provide the information listed above for such parent on a separate page.VI. Information on Your Spouses/Partners Parents.Topic/ItemYour Spouses/Partners MotherYour Spouses/Partners FatherName:_IF LIVING:Age:Age:Street Address (including City/State/Zip Code)_Telephone number_Description of financial status_How parents estate plan relates to you._Anticipated inheritance_Anticipated financial responsibility_Are you agent/executor etc.? Please describe._IF NOT LIVING:Date of death_Status of probate. Please attach copy of estate tax return._Any trusts or other planning affecting you. Please attach copy._If you have a step parent or adopted parents, please provide the information listed above for such parent on a separate page.VII. Information on Your Siblings. (Please attach additional pages if necessary).Name/RelationshipAddress/TelephoneAgeSexMaritalStatus/History/SpousesNameChildrenNamesAndAges1._ _F M _2._F M _3._F M _4._F M _5._F M _6._F M _7._F M _VIII. Information on Your Spouses/Partners Siblings. (Please attach additional pages if necessary).Name/RelationshipAddress/TelephoneAgeSexMaritalStatus/History/SpousesNameChildrenNamesAndAges1._F M _2._F M _3._F M _4._F M _5._F M _6._F M _7._F M _IX. Information on Your Children. (Please indicate with a * if from a prior marriage and with * if adopted).Name/Relationship/Other Parent NameAddress/TelephoneAgeSexMaritalStatusAnySpecialNeedsSpousesName/MaritalHistory1._F M _2._F M _3._F M _4._F M _5._F M _6._F M _7._F M _8._F M _X. Information on You