Tampa FL Estate Planning Questionnaire - Law Office of Mahmud Yennes

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? *

If not, of what country are you a citizen?

Is your spouse a citizen of the United States?

If not, of what country is he/she a citizen?

Have you ever made a will or a trust? *

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? *

Do you want to discuss setting up a living trust? *

Do you want to discuss giving someone your durable power of attorney to handle your financial affairs and bill paying? *

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? *

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? *

Do you want to discuss signing a declaration of preneed guardian in case a court finds you or your minor child incapacitated? *

Do you want to discuss anything else? Please list:

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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