..
CONFIDENTIAL
ESTATE PLANNING QUESTIONNAIRE
FOR
MARRIED PEOPLE
DATE:
Please
print or write legibly the following information.
If you need more space, use another sheet.
If you are not certain about an answer, leave the space
blank. Please bring this questionnaire with you, or mail it to me,
together with copies of relevant deeds, insurance policies,
divorce/dissolution judgments, marital agreements, etc. at the
time of your appointment.
HOME
ADDRESS AND TELEPHONE NUMBER:
INFORMATION
ON HUSBAND:
a.
Name you prefer to sign:
b.
Full name:
c.
Date and place of birth:
d.
Social Security Number:
e.
Are you a United States Citizen?
f.
Business address and telephone:
g.
Date came to California:
h.
Children of this marriage:
| Full
name |
Date
of Birth |
Address/Telephone
No. |
i.
Husband's children of prior marriages:
| Full
name |
Date of Birth |
Address/Telephone
No. |
j.
If you have any deceased children, please list below:
| Name |
Date
of Death |
Names
of deceased child's children |
k.
Names and address of parents (if living):
l.
If you have any support obligation to your parents,
please describe:
m.
Name and address of brothers and sisters:
n.
Describe any gifts or inheritances you expect to receive
from parents and others:
o.
Describe any beneficial interest you have in a trust
established by some other person:
p.
Describe any powers you have to designate who receives
irrevocable trust property at your death.
q.
If you are a custodian of property (under the California
Uniform Transfers and Minors Act or otherwise), or a trustee of
property for the benefit of your children
or others, please
describe:
r.
Please list any substantial gifts (over the annual
exclusion of $10,000 or $11,000 per year) you have made to
children or others:
INFORMATION
ON WIFE:
a.
Name you prefer to sign:
b.
Full name:
c.
Date and place of birth:
d.
Social Security Number:
e.
Are you a United States Citizen?
f.
Business address and telephone:
g.
Date came to California:
h.
Children of this marriage:
| Full
name |
Date
of Birth |
Address/Telephone
No. |
i.
Wife's
children of prior marriages:
| Full
name |
Date of Birth |
Address/Telephone
No. |
j.
If you have any deceased children, please list below:
| Name |
Date
of Death |
Names
of deceased child's children |
k.
Names and address of parents (if living):
l.
If you have any support obligation to your parents,
please describe:
m.
Name and address of brothers and sisters:
n.
Describe any gifts or inheritances you expect to receive
from parents and others:
o.
Describe any beneficial interest you have in a trust
established by some other person:
p.
Describe any powers you have to designate who receives
irrevocable trust property at your death.
q.
If you are a custodian of property (under the California
Uniform Transfers and Minors Act or otherwise), or a trustee of
property for the benefit of your children
or others, please
describe:
r.
Please list any substantial gifts (over the annual
exclusion of $10,000 or $11,000 per year) you have made to
children or others:
4.
Miscellaneous Information.
a.
If you signed a premarital or other property agreement,
please send a copy to Michael V. Vollmer.
b.
If you have a safe deposit box, give name of bank and
persons who have access:
c.
If you signed a buy/sell agreement concerning any
business interests, please send a copy to Michael V.
Vollmer.
d.
If you have Wills or Trusts presently in existence, please
send them to Michael V. Vollmer or bring them with you to your
appointment.
e. Date and
place of marriage:
Confidential
Asset List
As of (Date)
A. Real
estate: For each parcel, please list:
| Address |
type property |
value |
loan amount |
record title |
EXAMPLE:
123
Main Street
Orange, CA |
personal
residence |
$350,000 |
$150,000 |
joint
tenancy |
B. Promissory
notes owed to you
Name
of person who
owes you $ |
Secured?
(Yes or No) |
Amount
Owed to You |
How
do you hold
title? |
C. Securities
(stocks, bonds, partnerships)
Name
of Corporation
or Partnership |
Value |
Loans
Outstanding |
How
is Title Held? |
D. Closely
held business interests
| Value
of Your Interest |
Is
there a buy/ sell agreement? |
Name
of Entity |
How
is title held?
|
E. Employee
Benefits (pension plan, profit sharing plan, IRA, 40a(k), etc.
| Employer |
Type
of Plan (Pension/ Profit
Sharing/IRA) |
Name
of Employee |
Name
of Beneficiary
|
Present
Value |
F. Cash
and cash equivalents (checking accounts; certificates of
deposit, money market accounts, etc.)
| Name
of Institution |
Type
of Account |
How
is title held |
Amount |
G. Automobiles,
boats and other vehicles
| Year |
Make |
Present
Value |
Loans
owed |
How
is title held? |
H. Furniture,
furnishings, jewelry collections, etc.
| general
description |
value |
I. Life
insurance policies
| Name
of Company |
Policy
Number |
Name
of
Insured |
Name
of Owner |
.
.
| Face
Value |
Name
of Beneficiary |
Loans
owed
|
J.
Other assets (please describe and give value)
K. Liabilities
not shown above (please describe and give amount owed).
.
.
.
.
|
