PERSONAL AND FINANCIAL ORGANIZER FOR YOUR ESTATE PLANNING DOCUMENTS

Section 1 - General Information

Home Phone
Marital Status:	Married Single Divorced Widowed

You
Social Security #:
Date of birth:
US Citizen?	Yes No
Currently have a will or trust?	Yes No
If yes, give year and state in which prepared Expect to receive money or other assets from (check all that apply) Gift Inheritance Law suite Other

Your Spouse
Social Security #:
Date of birth:
US Citizen?	Yes No
Currently have a will or trust?	Yes No
If yes, give year and state in which prepared Expect to receive money or other assets from (check all that apply) Gift Inheritance Law suite Other

Your Legal Name:
Spouse's Legal Name:
Street Address:
City:
State:
Zip Code:

Mailing Address (if different)
Street Address:
City:
State:
Zip Code:

Your Employer:
Street Address:
City:
State:
Zip Code:
Your Occupation:
Work Phone:

Spouse's Employer:
Street Address:
City:
State:
Zip Code:
Spouse's Occupation:
Work Phone:

Section 2 - ABOUT YOUR CHILDREN

1. Legal Name:
Date of birth:
	Natural Legally Adopted Foster
Goes By:
Social Security No.:
	Married Needs Special Care Dependent
Street Address:
City:
State:
Zip Code:
Related To:	You Only Spouse Only Both

2. Legal Name:
Date of birth:
	Natural Legally Adopted Foster
Goes By:
Social Security No.:
	Married Needs Special Care Dependent
Street Address:
City:
State:
Zip Code:
Related To:	You Only Spouse Only Both

3. Legal Name:
Date of birth:
	Natural Legally Adopted Foster
Goes By:
Social Security No.:
	Married Needs Special Care Dependent
Street Address:
City:
State:
Zip Code:
Related To:	You Only Spouse Only Both

4. Legal Name:
Date of birth:
	Natural Legally Adopted Foster
Goes By:
Social Security No.:
	Married Needs Special Care Dependent
Street Address:
City:
State:
Zip Code:
Related To:	You Only Spouse Only Both

How Many Grandchildren do you have?
Yours Only?
Your Spouse's Only?

Section 3 - FINANCIAL INFORMATION

1. Do you own a home?	Yes No
2. Purchase Price?
3. Current Mortgage Balance?
4. Current Approximate Value?
5. Do you have an equity loan (2nd mortgage)?	Yes No
6. If yes, what is the amount?
7. Tile in whose name?
8. Do you own any other real estate?	Yes No
Please list out the any other real estate and please give a brief description.
Total Net Value of Real Estate?
9. Do you own any other titled property such as a car, boat, etc.?	Yes No
Please list out any other untilled property and give descriptions, locations, title in whose name, value and loan balances.
Total Net Value from other titled property?
10. Do you have any checking accounts?	Yes No
Please list all account numbers, approximate balances, whose name is on the account(s)
Total Net Value from checking accounts?
11. Do you have any interest bearing accounts (savings, money market, CDs)?	Yes No
Please list all account numbers, approximate balances, whose name is on the account(s)
Total Net Value from bank accounts?
12. Do you own any stocks, bonds or mutual funds (including company stock)?	Yes No
Please list all account numbers, approximate balances, whose name is on the account(s) and number of shares, etc.
Total Net Value from accounts?
13. Do you have any profit sharing IRAs or pension plans?	Yes No
Please list all account numbers, approximate balances, whose name is on the account(s) and number of shares, etc.
Total Net Value from accounts?
14.Do you or your spouse own a business?	Yes No
15.Do you or your spouse have any partnership or other business interests?	Yes No
Please list out all businesses including description, purchase price, current value and type of ownership.
Total Net Value of businesses?
16. Do you have any life insurance policies?	Yes No
17. Do you have any annuities?	Yes No
Please list name of the company, policy owner, beneficiary, 2nd beneficiary and death benefit.
Total Net Value of policies?
18. Does anyone owe you money?	Yes No
Please give an approximate value and give the names and addresses of the people that owe you the money
Total amount owed?
19. Do you have any special items of value (such as coin collections, antiques, jewelry, etc?
	Yes No
Please give a listing with approximate value and description of each item.
Total value?
20. What is the approximate total value of all your remaining personal property (whatever you own that has not been listed above like clothes, furniture, etc just an estimate?
21. Do you have any debts other than mortgage (s) and loans listed above (credit cards, personal loans, etc.?	Yes No
Please give a listing of loans.
Total debt?
22. Total value of everything you (and your spouse) own?
23. Total amount you (and your spouse) owe?
NET ESTATE =
24. Do you have a safe deposit box?	Yes No
25. In whose name?
26. Where is the safe deposit box located?

Section 4 - WILL AND TRUST DECISIONS

1. Executor (s) Manage your estate, (usually your spouse)
Choice Name:
Phone Number:
Street Address:
City:
State:
Zip Code:

2. Successor Executor(s), Steps in at your originally named executors incapacity, inability to act, refusal to act, or death. Please describe how your choice is related to you. Can be adult children, relative, trusted friend, bank, trust company. Please indicate if you wish any choice to act in a joint capacity.

Choice 1
Choice Name:
Related to you how?
Act in joint capacity?	Yes No
Phone Number:
Street Address:
City:
State:
Zip Code:

Choice 2
Choice Name:
Related to you how?
Act in joint capacity?	Yes No
Phone Number:
Street Address:
City:
State:
Zip Code:

Choice 3
Choice Name:
Related to you how?
Act in joint capacity?	Yes No
Phone Number:
Street Address:
City:
State:
Zip Code:

3. Trustee (s) - Manages your trust now, usually you (and your spouse).

Choice 1
Choice Name:
Related to you how?
Act in joint capacity?	Yes No
Phone Number:
Street Address:
City:
State:
Zip Code:

4. Successor Trustee(s) - Steps in at your originally named executors incapacity, inability to act, refusal to act, or death. Please describe how your choice is related to you. Can be adult children, relative, trusted friend, bank, trust company. Please indicate if you wish any choice to act in a joint capacity.

Choice 1
Choice Name:
Related to you how?
Act in joint capacity?	Yes No
Phone Number:
Street Address:
City:
State:
Zip Code:

Choice 2
Choice Name:
Related to you how?
Act in joint capacity?	Yes No
Phone Number:
Street Address:
City:
State:
Zip Code:

Choice 3
Choice Name:
Related to you how?
Act in joint capacity?	Yes No
Phone Number:
Street Address:
City:
State:
Zip Code:

6. Guardian for Minor or Disabled Children. Responsible adult who will raise your minor children if something happens to you. Describe how your choice is related to you.

Choice 1
Choice Name:
Related to you how?
Act in joint capacity?	Yes No
Phone Number:
Street Address:
City:
State:
Zip Code:

Choice 2
Choice Name:
Related to you how?
Act in joint capacity?	Yes No
Phone Number:
Street Address:
City:
State:
Zip Code:

Section 5 - BENEFICIARIES

1. Special Gifts to Organizations
Do you want to make a gift (cash or a specific item) to a charity, foundation, religious or fraternal organization?
Yes No
Please list the name of the organizations including a description of the gift and address of the organizations. If you are married, do you wish the gifts outlined above to be made from you and your spouse?
Yes No
If you answered No above, please specify which spouse will make which gifts.

2. Special Gifts to Individuals
Do you want to give any specific items to a family member or other individual? (For example: wedding ring to your daughter, watch to a son or nephew, etc...)
Yes No
Please list the description of the gift, name of the person and their address.
If you are married, do you wish the gifts outlined above to be made from you and your spouse?
Yes No
If you answered No above, please specify which spouse will make which gifts.

3. Beneficiaries
Who do you want to receive the rest of your estate after special gifts have been distributed? You can designate a dollar amount or a percentage.

Please list the name of the person and/or organization including address and specify the amount or percentage.
If you are married, do you wish the gifts outlined above to be made from you and your spouse?
Yes No
If you answered No above, please specify which spouse will make which gifts.

5. Do you provide for someone who requires special care
Do any of your dependents (aging parents, disabled child) require special care?
Yes No
Are you currently receiving government benefits?
Yes No
Is there someone else you want to provide for who is not related to you (significant other, special friend, pet)?
Yes No
Please list the names, address, age and relationship with a short description.

6. Alternate Beneficiaries
Who do you want to receive your estate if you (and your spouse) outlive the Beneficiaries you have named above?
Name of person/organization, address and amount or percentage.
If you are married, do you wish the gifts outlined above to be made from you and your spouse?
Yes No
If you answered No above, please specify which spouse will make which gifts.

7. Disinheriting
Are there any relatives that you specifically do not want to receive anything from your estate?

Section 6 - SPECIAL INSTRUCTIONS AT INCAPACITY

1. Keeping/Selling Assets:
If it becomes necessary to sell assets to pay for your or your spouse's care, are there certain ones you prefer to be sold first?
Yes No
Please list
Are there potential buyers you want contacted?
Yes No
Please list
Are there certain assets you prefer not be sold unless absolutely necessary?
Yes No
Please list.
2. Medical Care:
Do you prefer (or want to avoid) a certain hospital/nursing home?
Yes No
Please list
Do you have strong feelings about blood transfusions, life support, etc.?
Yes No
You

Your Spouse


3. Do you want a Living Will?
Yes No

*This lets others know how you feel about your life support treatment if you become terminally ill.- there is no additional charge for this.*

4. Do you want a Durable Power of Attorney for Health Care?
Yes No

*There is no additional charge for this*

This document lets you choose the person you want to make any health care decisions (including life support) for you if you are unable to make them for yourself, keeping these personal decisions out of the court. You can choose anyone you trust: your spouse, friend or other relative, etc. List your choices below:

You

Choice 1
Choice Name:
Related to you how?
Phone Number:
Street Address:
City:
State:
Zip Code:

Choice 2
Choice Name:
Related to you how?
Phone Number:
Street Address:
City:
State:
Zip Code:

Choice 3
Choice Name:
Related to you how?
Phone Number:
Street Address:
City:
State:
Zip Code:

Your Spouse

Choice 1
Choice Name:
Related to you how?
Phone Number:
Street Address:
City:
State:
Zip Code:

Choice 2
Choice Name:
Related to you how?
Phone Number:
Street Address:
City:
State:
Zip Code:

Choice 3
Choice Name:
Related to you how?
Phone Number:
Street Address:
City:
State:
Zip Code:

5. Do you want a Durable Power of Attorney for Property?
Yes No
*There is no additional charge for this*
This document lets you choose the person you want to make any property decisions (during your life) for you if you are unable to make them for yourself, keeping these personal decisions out of the court. You can choose anyone you trust: your spouse, friend or other relative, etc. List your choices below:

You

Choice 1
Choice Name:
Related to you how?
Phone Number:
Street Address:
City:
State:
Zip Code:

Choice 2
Choice Name:
Related to you how?
Phone Number:
Street Address:
City:
State:
Zip Code:

Choice 3
Choice Name:
Related to you how?
Phone Number:
Street Address:
City:
State:
Zip Code:

Your Spouse

Choice 1
Choice Name:
Related to you how?
Phone Number:
Street Address:
City:
State:
Zip Code:

Choice 2
Choice Name:
Related to you how?
Phone Number:
Street Address:
City:
State:
Zip Code:

Choice 3
Choice Name:
Related to you how?
Phone Number:
Street Address:
City:
State:
Zip Code:

Section 7 - DOCUMENTS TO BRING FOR YOUR INTERVIEW

Please bring any of the following documents that you may have in your possession to your interview with us:

Prior Will(s)
Prior Trust(s)
Deeds to All Property Currently Owned
Title Insurance Policies
All Life Insurance Certificates
Titles to Cars, Boats, etc...
IRA, Pension, Profit Sharing, 401 (k) or other Deferred Compensation Plans & Statements
Last Statements of Accounts, eg. Bank, Investment, Mutual Funds, Money Market, C.D.'s etc...
Last Three Years U.S. Income Tax Return
Any Prenuptial or Postnuptial Agreements
Any Prior Divorce Decrees
Property Insurance Policies
Any Documentation regarding Business Ownership, Buy-Sell Agreements, Employment Agreements, etc...
Any Other Relevant Documentation

Section 8

QUESTIONS TO ASK JOSEPH M. LUCAS & ASSOCIATES, L.L.C. ATTORNEYS

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