Jennifer L. Wilkerson
A PROFESSIONAL CORPORATION
ATTORNEY AT LAW
CERTIFIED SPECIALIST IN ESTATE
PLANNING, TRUST AND PROBATE LAW
State Bar of California Board of Legal Specialization
140 Litton Drive, Suite 204
Grass Valley CA 95945
Telephone: 530-272-4292
Fax: 530-272-5546
jenwilk@jwilkerson.net
www.jwilkerson.net
WILL/TRUST QUESTIONNAIRE
MARRIED COUPLES
Thank you for taking the time to complete the information below for my review. I have found that this
allows me to be more efficient and thus keep costs down. This also may be helpful to you in organizing the
information we need to discuss regarding your estate plan.
FAMILY INFORMATION
Date: ______________________________________
1.
Name
(as it appears on your Driver=s License or Senior I.D. card)
Is your name shown differently on any legal documents? If so, please list other names:
DOB
Parents' names
SSN
Place of birth
2.
Spouse=s Name
(as it appears on your Driver=s License or Senior I.D. card)
Is your name shown differently on any legal documents? If so, please list other names:
DOB
Parents' names
SSN
Place of birth
3.
Date of Marriage
4.
If yes, please indicate year of divorce or death:
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Any Prior Marriages?
 Yes
 No
5.
Names and Ages of Children
_______________________________________________________________
Date of birth: _____________________
_______________________________________________________________
Date of birth: _____________________
_______________________________________________________________
Date of birth: _____________________
_______________________________________________________________
Date of birth: _____________________
_______________________________________________________________
Date of birth: _____________________
6.
Please indicate if any of the above are step or adopted children.
7.
Is any family member not a U.S. Citizen?
8.
Are your parents living?
You:
 Yes
 No
Spouse:
 Yes
 No
9.
Are brothers/sisters living?
You:
 Yes
 No
Spouse:
 Yes
 No
Names:
10.
11.
Have you ever served in the United States military? You:
 Yes  No
Spouse:  Yes  No
If yes, are you receiving veteran=s benefits?
 Yes  No
Spouse:  Yes  No
You:
Estate Planning Goals. What are your goals in completing an estate plan? Please check all that apply:
a.
b.
c.
d.
e.
f.






Assuring distribution of my assets to my intended Beneficiaries.
Assuring funds are available for the support of young children, or grandchildren.
Providing funds for education of children, or grandchildren.
Managing cash flow for my retirement.
Minimizing current income taxes.
Minimizing future estate, gift and generation skipping taxes
g.
h.
i.
j.
k.
l.
m.
n.








Transferring assets to my children during my lifetime.
Assisting my children, or grandchildren, to learn financial responsibility.
Protecting assets from possible creditors, divorcing spouses, or >spendthrift= beneficiaries.
Leaving a legacy through gifts to charities.
Developing a care plan for future health and personal needs.
Creating a system to organize personal financial records, including estate planning documents.
Planning for your personal electronic data (email, online accounts, stored data).
Other:_________________________________________________________________________________________
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PLAN FOR DISPOSITION OF ESTATE
12.
Specific Gifts. Please list any gifts of specific items you wish to make:
Item
Beneficiary
13.
Gift of Residue. Please describe your intended distribution of your remaining estate:
14.
Alternative Distribution. Please indicate who should receive your estate if the beneficiaries listed
above should predecease you.
15.
Charitable Gifts.
If you wish to leave a legacy through gift to charities, what are your personal motivations and charitable
interests?
16.
Trust for Minor Children/Grandchildren. If you have minor children or grandchildren, who would
you want to act as Trustee to administer their share of the estate?
17.
1st Choice:
2nd Choice:
Address:
Address:
At what age should the Trust terminate and the children/grandchildren receive their share
outright? ______________ (Your Trustee may use trust funds for the children/grandchildren prior to this
age, such as for education.)
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18.
Guardian of Minor Children. If you have minor children, who would you want to be responsible for
their physical care? (Note: The Guardian may be the same person as the Trustee handling the child's
money, or these roles could be assigned to different people.)
1st Choice:
2nd Choice:
Address:
Address:
 Yes
 No
19.
Is any beneficiary disabled, or require a "special needs" trust?
If yes, indicate beneficiary and nature of disability:
20.
Executor/Trustee. Who do you wish to administer your estate or trust upon your death
(e.g., pay final bills, sell assets if needed, and distribute estate)?
1st Choice:
Name
Address
2nd Choice:
3rd Choice:
 Yes
 No
21.
Will you waive the requirement of a surety bond for your executor or trustee?
22.
Any additional provisions. You may wish to include provisions such as burial or funeral instructions.
23.
Do you have a Safe Deposit Box?
Box number
 Yes
 No
Location
24.
Please provide a copy of any prior Wills or Trusts to our office before your appointment.
25.
Other Professional Relationships:
CPA/Tax Preparer
Financial/Investment Advisor(s)
Life Insurance Agent
Minister/Clergy
Other
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INFORMATION REGARDING ASSETS
Please Note: If you are interested in a Revocable Living Trust, please complete all of the information requested at this
time. If you do not wish to consider a Revocable Living Trust, you may disregard the questions marked with an asterisk
(*).
26.
Do you own any Real Property?
 Yes
 No
*NOTE: Please bring a copy of your Deed(s) with you to your appointment.
Principal Residence located:
Fair market value (approximate):
Amount of any encumbrances:
Original purchase price and date of purchase:
How title is held (tenancy in common, joint tenancy, community property, separate property)?
*
Assessor's parcel no. (APN):
Property no. 2 located:
Fair market value (approximate):
Amount of any encumbrances:
Original purchase price and date of purchase:
How title is held (tenancy in common, joint tenancy, community property, separate property)?
*
Assessor's parcel no. (APN):
27.
Cash Accounts: Include Savings, Credit Union, Money Market, Certificates of Deposit (CD=s), etc.
Bank & Branch*, type of account* and account no.*, approx. balance, authorized signers on account:
28.
Do you own any stocks/bonds/mutual funds?
 Yes
 No
As to each, please list number of shares*, name of stock or fund, type of bond and face amount, (approx.)
present value, date acquired and original purchase price (best guess if exact figure unavailable):
29.
Life Insurance/Annuities. For each policy, please give the following information: Policy number*,
company, amount, type (term, whole life, group) designated beneficiaries:
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30.
IRA=s/Retirement Benefits (list and briefly describe any IRA and retirement benefit accounts).
IRA=s:
Would you like to discuss the substantial income tax savings available by naming a beneficiary other
than your spouse for some or all of your IRA?
 Yes
 No
In what year will you begin mandatory withdrawals (i.e., at age 70 1/2)?
Retirement Accounts:
Company:
Type of Plan
Present value (approx.)
Receiving monthly payments?
Do you expect to Arollover@ your plan benefits to an IRA account?
 Yes
 Yes
 No
 No
31.
Tangible Personal Property (list and briefly describe items of tangible personal property worth over
$1,000, such as cars, jewelry, artwork, antiques, etc.):
32.
Other Assets:
Please list & describe other assets worth over $1000, such as airline miles accounts, royalties,
copyrights, patents, etc.
33.
Do you own a business?
 Yes
 No
Name of Business:
Business form (e.g., sole Proprietorship, partnership, corporation):
Assets of Business and Net Worth:
Is there a Buy-Sell Agreement in place?  Yes
 No
Who would continue managing the business in the event of your death?
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 Yes
 No
34.
Do you own interest in any limited partnerships, reits, etc.?
If so, please list name and amount of each investment:
35.
Notes Receivable. Does anyone owe you money (including family members)?  Yes
 No
Please list amount and payment schedule. Do you hold a Promissory Note or Deed of Trust?
Are any of these loans to be forgiven upon your death?
36.
 Yes
 No
Other Interests or Expectancies (list and briefly describe any interests you have in a trust, powers of
appointment, or expected inheritances or gifts.
RECAPITULATION:
Approximate value: Please indicate the characterization of your assets as community or separate property.
Community
Property
Husband’s Separate
Property
Wife’s
Separate Property
Real property
Less: encumbrances
(
)
(
Cash accounts
Stocks/Bonds/Mutual
Funds
Life Insurance
Annuities/IRA's
Pension/Death benefits
Tangible personal
property
Business Interests
Ltd. Partnerships, reits
Promissory notes
Other
Total:
37.
Please list any debts, liabilities or other obligations:
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)
(
)
38.
Gifts Made. List and briefly describe any gifts made to others over $10,000. Please indicate the date
and amount of the gift, the recipient, whether outright gift or in trust, and if gift tax return was filed:
39.
Please list your monthly sources of income: (approximate)
Husband
Wife
Monthly Total
a. Wages
b. Social Security
c. Pension/IRA
d. Interest/Dividends
e. Other
 Yes
 No
40.
Do you have Long Term Care Insurance?
41.
Do you have or are you interested in a Durable Power of Attorney for Financial Matters?
42.
Husband:
 Yes, I am interested
 No thanks, I have one signed on
Wife:
 Yes, I am interested
 No thanks, I have one signed on
Do you have or are you interested in an Advance Health Care Directive?
Husband:
 Yes, I am interested
 No thanks, I have one signed on
Wife:
 Yes, I am interested
 No thanks, I have one signed on
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