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Estate Planning Worksheet (Single)

Estate Planning Worksheet (Single)

Please complete this questionnaire to the best of your ability and click submit so that we can review it prior to our meeting.

If you need assistance completing the information, call our office (845-255-4400) and we will help you.

DON’T WORRY ABOUT TOTAL ACCURACY – JUST DO THE BEST YOU CAN

WE LOOK FORWARD TO SEEING YOU!!!

Your Information
Todays Date
MM slash DD slash YYYY
Personal Data
Name
First Middle Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Email
Birth Date
U.S. Citizen
- Yes
- No
Children
I have children
- YES
- NO
Name of Child
First Middle Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Email
Birth Date
Name of Child 2
First Middle Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Email
Birth Date
Name of Child #3
First Middle Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Email
Birth Date
Name of Child #4
First Middle Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Email
Birth Date
Name of Child #5
First Middle Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Email
Birth Date
Important Family Questions:
Do you have a child that is a spendthrift?
- YES
- NO
Do you have a child with a learning disability?
- YES
- NO
Do any of your children receive governmental support or benefits?
- YES
- NO
Do you have any adopted children?
- YES
- NO
Do any of your children have special education, medical, or physical needs?
- YES
- NO
Do any of your family members have any problems with drug or alcohol addiction?
- YES
- NO
Are any of your children institutionalized?
- YES
- NO
Are you or your spouse receiving social security, disability, or other governmental benefits?
- YES
- NO
Do you provide primary or other major financial support to adult children?
- YES
- NO
Have either you or your spouse been divorced?
- YES
- NO
Are you making payments pursuant to a divorce or property settlement agreement? (Please furnish a copy when we meet.)
- YES
- NO
Have you or your spouse been widowed? (If a Federal estate tax or State death tax return was filed, please furnish a copy when we meet.)
- YES
- NO
Have you or your spouse completed previous Health Care Powers of Attorney or Living Wills? (Please furnish copies when we meet.)
- YES
- NO
Have you or your spouse completed previous wills, trusts, or estate planning? (Please furnish copies when we meet.)
- YES
- NO
Are you and your spouse United States citizens?
- YES
- NO
If you answered “NO,” are either you or your spouse a resident or a non-resident alien?
- YES
- NO
Does you have any children by a previous marriage?
- YES
- NO
Assets and Liabilities
Please insert the approximate value of each asset/liability in the appropriate space.
Row 1 Column 1
Personal Effects/Household Items
Row 1 Column 1 End
Row 1 Column 2 Start
Value
Row 1 Column 2 End
Row 1 Column 3 Start
Joint
Row 1 Column 3 End
Row 1 Column 4 Start
Liabilities
Row 1 Column 4 End
Row 1 End
CSS Ready Classes
Built in CSS classes in Gravity forms...
Personal Effects/Household Items
Value
Joint
Liabilities
Automobile
Value
Joint
Liabilities
Checking Account
Value
Joint
Liabilities
Savings Account
Value
Joint
Liabilites
Money Market Accounts
Value
Joint
Liabilites
Certificates of Deposit
Value
Joint
Liabilites
Residence (Assessed Value)
Value
Joint
Liabilites
Other Real Estate
Value
Joint
Liabilites
Additional Automobiles
Value
Joint
Liabilites
Mutual Funds
Value
Joint
Liabilites
Stocks
Value
Joint
Liabilites
Bonds
Value
Joint
Liabilites
Annuities
Value
Joint
Liabilites
Cash Value - Life Insurance
Value
Joint
Liabilites
IRA
Value
Joint
Liabilites
Other
Value
Joint
Liabilites
Other
Value
Joint
Liabilites
What did you pay for your current home including any improvements
Address of any real property other than personal residence:
Address 1:
Street Address Address Line 2 City State ZIP Code
Tax Block # / Lot #:

Can be obtained from Tax Bill
Address 2:
Street Address Address Line 2 City State ZIP Code
Tax Block # / Lot #:

Can be obtained from Tax Bill
Address 3:
Street Address Address Line 2 City State ZIP Code
Tax Block # / Lot #:

Can be obtained from Tax Bill

Online Forms

Estate Planning Goals
Estate Planning Worksheet (Single)
Estate Planning Worksheet (Couples)

Peace of Mind

Have you addressed the necessity of having a proper estate plan in place? Are you confident that the estate plan you currently have takes advantage of all available options for avoiding probate or saving taxes or for ensuring the seamless transfer of your wealth? Are you concerned that your assets may be dissipated in a long-term care facility?

As estate planning attorneys, we ensure that these and many other questions are thoroughly analyzed and addressed.

Latest News

Looking for the latest information for Estate or Retirement Planning, or changes to laws and regulations that could affect you? See recent posts below:

Nuts and Bolts of Trusts, Part 1
Getting Comfortable with an Irrevocable Trust
Asset Protection with Trusts – Testing the Limits

Contact Us

845-255-4400

james@jgylaw.com

3 Academy Street
New Paltz, NY 12561

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