FAMILY LAW ATTORNEY NEAR ME

Hillsborough County

11256 Boyette Rd, Riverview, FL 33569

Pasco County

2236 Ashley Oaks Circle, Ste. 102 Wesley Chapel, FL 33544

Riverview

(813) 850-0025

Wesley Chapel

(352) 514-6865

You Have Reached the Family Law Offices of Summerfield Law, Riverview & Wesley Chapel, FL

ESTATE PLANNING QUESTIONNAIRE

Applicant

Name
(as it should appear on your docs)
MM slash DD slash YYYY

Spouse

Spouse's Name
(as it should appear on your docs)
MM slash DD slash YYYY
Address

i. Last Will and Testament

Name of child
Name of child
Is child from a prior relationship?
If so, who is the parent?
Address
Phone
 

Intended Beneficiaries

Names of beneficiary
Names of beneficiaries
Relationship
Address
Phone
 
Do you desire cremation?
Are you entitled to veteran's funeral
Do you have a prepaid funeral plan

Personal Representative

Please choose one personal representative (executor)/trustee and one alternate.
Personal Representative
Name
Relationship
Address
Phone
 

Specific Gifts

Specific Gifts
Name
Item
Location of Item
 

ii. Living Will and Designation of Health Care Surrogate

Living Will and Designation of Health Care Surrogate
Name
Relationship
Address
Phone
 

iii. Durable Power of Attorney and Designation of Attorney-in-Fact

Durable Power of Attorney and Designation of Attorney-in-Fact
Name
Relationship
Address
Phone
 

Asset Information

1. Bank Accounts
Bank Name
Type of account
Approximate balance
 
2. Investment Accounts/Retirement Accounts
Company
Type of account (IRA, Pension, 401K)
Is the total of all your assets over $10 million
 
4. Insurance policies
Company/Agent
Beneficiary
Value
Term or Whole Life
Account Number
 
5. Real estate
Location/Address
Value
Type of ownership
 
Type (primary, rental, vacation, land)
6. Business interests
Interest in a business, corp, LLC?

Make an Appointment

Name(Required)