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Wills, Trusts, And
Estates. Planning For Their Future.
Below is a questionnaire to help us assess your situation. Fill the form to the best of your ability.
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Please enable JavaScript in your browser to complete this form.
Services Needed
*
Creation of a Florida Will
Modification of a Florida Will
Creation of a Florida Trust
Florida will that includes a testamentary trust
Discuss Options with an Attorney
Power of Attorney
Your Name
*
First
Last
Date of Birth
*
Spouses Name
First
Last
Date of Birth
Your Home Address
*
Your Email
*
Your Phone Number
*
Social Security #
*
Are you a United States citizen?
*
[Must Pick Yes or No]
Yes
No
If not, of what country are you a citizen?
If Answer to the previous Question is No, Pick the Country of your Citizenship
N/A (US Citizen)
Afghanistan
Albania
Algeria
Andorra
Angola
Anguilla
Antigua & Barbuda
Argentina
Armenia
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia & Herzegovina
Botswana
Brazil
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
China - Hong Kong / Macau
Colombia
Comoros
Congo
Congo, Democratic Republic of (DRC)
Costa Rica
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Fiji
Finland
France
French Guiana
Gabon
Gambia, Republic of The
Georgia
Germany
Ghana
Great Britain
Greece
Grenada
Guadeloupe
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hungary
Iceland
India
Indonesia
Iran
Iraq
Israel and the Occupied Territories
Italy
Ivory Coast (Cote d'Ivoire)
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Korea, Democratic Republic of (North Korea)
Korea, Republic of (South Korea)
Kosovo
Kuwait
Kyrgyz Republic (Kyrgyzstan)
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Moldova, Republic of
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar/Burma
Namibia
Nepal
New Zealand
Nicaragua
Niger
Nigeria
North Macedonia, Republic of
Norway
Oman
Pacific Islands
Pakistan
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Puerto Rico
Qatar
Reunion
Romania
Russian Federation
Rwanda
Saint Kitts and Nevis
Saint Lucia
Saint Vincent and the Grenadines
Samoa
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovak Republic (Slovakia)
Slovenia
Solomon Islands
Somalia
South Africa
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Sweden
Switzerland
Syria
Tajikistan
Tanzania
Thailand
Netherlands
Timor Leste
Togo
Trinidad & Tobago
Tunisia
Turkey
Turkmenistan
Turks & Caicos Islands
Uganda
Ukraine
United Arab Emirates
United States of America (USA)
Uruguay
Uzbekistan
Venezuela
Vietnam
Virgin Islands (UK)
Virgin Islands (US)
Yemen
Zambia
Zimbabwe
Is your spouse a citizen of the United States?
[Must Pick Yes or No]
Yes
No
If not, of what country is he/she a citizen?
If Answer to the previous Question is No, Pick the Country of your Citizenship
N/A (US Citizen)
Afghanistan
Albania
Algeria
Andorra
Angola
Anguilla
Antigua & Barbuda
Argentina
Armenia
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia & Herzegovina
Botswana
Brazil
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
China - Hong Kong / Macau
Colombia
Comoros
Congo
Congo, Democratic Republic of (DRC)
Costa Rica
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Fiji
Finland
France
French Guiana
Gabon
Gambia, Republic of The
Georgia
Germany
Ghana
Great Britain
Greece
Grenada
Guadeloupe
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hungary
Iceland
India
Indonesia
Iran
Iraq
Israel and the Occupied Territories
Italy
Ivory Coast (Cote d'Ivoire)
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Korea, Democratic Republic of (North Korea)
Korea, Republic of (South Korea)
Kosovo
Kuwait
Kyrgyz Republic (Kyrgyzstan)
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Moldova, Republic of
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar/Burma
Namibia
Nepal
New Zealand
Nicaragua
Niger
Nigeria
North Macedonia, Republic of
Norway
Oman
Pacific Islands
Pakistan
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Puerto Rico
Qatar
Reunion
Romania
Russian Federation
Rwanda
Saint Kitts and Nevis
Saint Lucia
Saint Vincent and the Grenadines
Samoa
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovak Republic (Slovakia)
Slovenia
Solomon Islands
Somalia
South Africa
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Sweden
Switzerland
Syria
Tajikistan
Tanzania
Thailand
Netherlands
Timor Leste
Togo
Trinidad & Tobago
Tunisia
Turkey
Turkmenistan
Turks & Caicos Islands
Uganda
Ukraine
United Arab Emirates
United States of America (USA)
Uruguay
Uzbekistan
Venezuela
Vietnam
Virgin Islands (UK)
Virgin Islands (US)
Yemen
Zambia
Zimbabwe
Have you ever made a will or a trust?
*
Yes
No
Occupation
*
Resided in Florida since
*
Your children, their spouses, and their children - Indicate which, if any, of your children is your child but not your spouse's, or vice versa. Also show the date and place of adoption of any adopted child. Be sure to include any deceased child and indicate the date of the child's death and his or her surviving spouse and children.
If either you or your spouse has been married previously, state the name of each prior spouse and indicate whether he or she is now living (if living give his or her address).
Is there other important personal information that might affect your estate plans? For example, does a member of your family have a serious long-term medical or physical problem that will require special care or attention in the future?
Safe deposit box is at
Accountant
Life Insurance Agent
Stock Broker
Spouses Name
First
Last
Spouse Address
Spouse Phone
Child (1) Name
First
Last
Child (1) Address
Child (1) Phone
Child (2) Name
First
Last
Child (2) Address
Child (2) Phone
Child (3) Name
First
Last
Child (3) Address
Child (3) Phone
Child (4) Name
First
Last
Child (4) Address
Child (4) Phone
Child (5) Name
First
Last
Child (5) Address
Child (5) Phone
Spouse Child (1) Name
First
Last
Spouse Child (1) Address
Spouse Child (1) Phone
Spouse Child (2) Name
First
Last
Spouse Child (2) Address
Spouse Child (2) Phone
Spouse Child (3) Name
First
Last
Spouse Child (3) Address
Spouse Child (3) Phone
Parents Name (Father)
First
Last
Parents Address (Father)
Parents Phone (Father)
Parents Name (Mother)
First
Last
Parents Address (Mother)
Parents Phone (Mother)
Spouse Parents Name (Father)
First
Last
Spouse Parents Address (Father)
Spouse Parents Phone (Father)
Spouse Parents Name (Mother)
First
Last
Spouse Parents Address (Mother)
Spouse Parents Phone (Mother)
Siblings (Brothers & Sisters)
Spouse Siblings (Brothers & Sisters)
Persons Not Listed Above To Whom You Want To Leave Something
In case of your incapacity, who would you want to take care of your: Financial decisions and bill paying:
In case of your incapacity, who would you want to take care of your: Health decisions
At your death, who do you want to take care of Administering your estate (personal representative)
At your death, who do you want to take care of Your minor children’s financial affairs (guardian of property)
At your death, who do you want to take care of Your minor children’s medical/personal decisions (guardian of person)
Life Insurance Assets (In Your Name)
Life Insurance Assets (In Your Name & Your Spouse)
Life Insurance Assets (In Your Spouse Name)
Home (In Your Name)
Home (In Your Name & Your Spouse)
Home (In Your Spouse Name)
Other Real Estate(In Your Name)
Other Real Estate(In Your Name & Your Spouse)
Other Real Estate (In Your Spouse Name)
Stocks, Bonds, Etc. (In Your Name)
Stocks, Bonds, Etc. (In Your Name & Your Spouse)
Stocks, Bonds, Etc. (In Your Spouse Name)
Bank, Savings, CD’s, Money Markets, Etc (In Your Name)
Bank, Savings, CD’s, Money Markets, Etc. (In Your Name & Your Spouse)
Bank, Savings, CD’s, Money Markets, Etc. (In Your Spouse Name)
IRA’s, Pensions, Etc. (In Your Name)
IRA’s, Pensions, Etc. (In Your Name & Your Spouse)
IRA’s, Pensions, Etc. (In Your Spouse Name)
Furnishings, Jewelry, Autos, & Tangible Property (In Your Name)
Furnishings, Jewelry, Autos, & Tangible Property (In Your Name & Your Spouse)
Furnishings, Jewelry, Autos, & Tangible Property (In Your Spouse Name)
Inheritances Expected (In Your Name)
Inheritances Expected (In Your Name & Your Spouse)
Inheritances Expected (In Your Spouse Name)
Other Assets (In Your Name)
Other Assets (In Your Name & Your Spouse)
Other Assets (In Your Spouse Name)
Please list the persons to whom you want to leave your assets at your death. Also, list alternates to receive each gift in case the person you name dies before you. (a) Special gifts of jewelry, furnishings, autos, collections, and other tangible property (please state whether the cost of delivery should be paid by the estate or by the beneficiary)
Please list the persons to whom you want to leave your assets at your death. Also, list alternates to receive each gift in case the person you name dies before you. Gift of all remaining tangible property:
Please list the persons to whom you want to leave your assets at your death. Also, list alternates to receive each gift in case the person you name dies before you. Special gifts of cash, stock or other specific items:
Please list the persons to whom you want to leave your assets at your death. Also, list alternates to receive each gift in case the person you name dies before you. Gift of all remaining assets (residue):
From whose share of the will do you want estate taxes paid?
*
Each gift pays its own share.
All taxes are paid from the residue.
Other: [Will Define]
(Generally, there is no federal estate tax for assets less than $1.5 million.)
Who do you want to pay estate taxes on property passing outside probate (not under the will)?
*
The person who receives the property.
The residue of the will.
Other [Will Define]
List anyone (such as minor children) for whom you want assets held in trust instead of being distributed to them at your death, so that the trustee invests and distributes the assets on a certain schedule until the beneficiaries can do so alone: [Names of minors].
Who do you want to be the trustee (may be bank or individual)?
Please provide alternates for the role of trustee:
List the age at which you want the beneficiary or beneficiaries to begin directly receiving income from the trust (e.g., age 21):
List the ages at which you want the beneficiary or beneficiaries to receive the principal (e.g., in thirds at ages 25, 30 and 35):
Do you want to discuss the effect of holding assets in joint names with others?
*
Must Pick Yes or No
Yes
No
Do you want to discuss setting up a living trust?
*
[Must Pick Yes or No]
Yes
No
Do you want to discuss giving someone your durable power of attorney to handle your financial affairs and bill paying?
*
[Must Pick Yes or No]
Yes
No
Do you want to discuss signing a living will to express your desires concerning the use or nonuse of medical procedures to prolong your life in case of terminal illness?
*
[Must Pick Yes or No]
Yes
No
Do you want to discuss signing a designation of health care surrogate to give someone power to make medical decisions for you if you are unable to do so?
*
[Must Pick Yes or No]
Yes
No
Do you want to discuss signing a declaration of preneed guardian in case a court finds you or your minor child incapacitated?
*
[Must Pick Yes or No]
Yes
No
Do you want to discuss anything else? Please list:
Name
Submit
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Practice
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Personal Injury Lawyer in Tampa
Car Accident Lawyer in Tampa
Motorcycle Accidents
Truck Accidents
Bicycle Accidents
Wrongful Death
Slip and Fall
Pedestrian Accidents
Criminal Defense
Criminal Defense
DUI & BUI
Traffic Infractions
Real Estate
Real Property Law
Realtor Services
Title & Closing
Insurance Defense
Bad Faith Insurance Claims
Florida Hurricane Insurance Claim Disputes
Legal Areas
Bankruptcy
Business Consulting
Contracts & Business
Estate Planning
FDA Compliance and Regulatory Guidance Services
FDA Label Review
FDA Registration
FDA Compliance – Request Form
Immigration
Immigration Qualification Form
Immigration From the Middle East to America
Frequently Asked Immigration Questions
Free Consultation
Make a Payment
Tampa Office
3702 W Spruce St #1076
Tampa, FL 33607
T:
(813)461-4473
E:
[email protected]
Mahmud Yennes, ESQ.