Sylvia Noel White Final Logo

1108 S. Highland Avenue 
Clearwater, FL 33756
727-735-0645
800-338-7370
contact

ESTATE PLANNING QUESTIONNAIRE

This Estate Planning Questionnaire is designed to help you decide your estate plans, and to help us in advising you
and drafting the documents you will need to carry out your plans. Please think about each of the items listed below and
jot down your answers. When we discuss the details of your estate plans, you can refer to this form to answer our
questions. Of course, any information you provide to us will be kept strictly confidential.
.


1. Please tell us about yourself..

Full Name *

Please type your full name.
E-mail *

Invalid email address.
Phone Number *

Invalid Input Use this format please: 555-555-5555
Address *

Invalid Input
Street *

Invalid Input
Zip Code *

Invalid Input
Is this your permanent address? If not please enter that information below. *

Invalid Input
Address

Invalid Input
Street

Invalid Input
Zip Code

Invalid Input
Do you have a will now? *

Invalid Input
If you do, where and when was it signed?

Invalid Input
Have you ever been divorced?

Invalid Input
As part of your divorce, did you promise to pay money or leave anything to your ex-spouse?

Invalid Input

2. Now, please tell us about your spouse. (If you're not married, you can skip to the next part)

Full Name

Please type your full name.
Address

Invalid Input
Street

Invalid Input
Zip Code

Invalid Input
Is this his/her permanent address

Invalid Input
Address

Invalid Input
Street

Invalid Input
Zip Code

Invalid Input
Do you have a will now? *

Invalid Input
If you do, where and when was it signed?

Invalid Input
Has your spouse ever been divorced?

Invalid Input
If so, is his/her ex-spouse still alive?

Invalid Input
As part of the divorce, did your spouse promise to pay money or leave anything to her/his ex-spouse?

Invalid Input
Please list your children (by full name, age, and city of residence) and tell us whether they are children of the
current marriage, or of any previous marriage of you or your spouse.

Invalid Input

3. Please tell us about your children. (If you have no children, you can skip to the next part)

If there are any children you want to disinherit, please list them.

Invalid Input
4. Tell who you want as executor or personal representative.
About each possible executor or personal representative, tell us the person's name, the person's approximate age,
the person's city/state of residence, and the person's relationship to you.
[A close relative can be your personal representative even if he/she is not a Florida resident] *

Invalid Input
5. If you have minor or disabled children, tell us who you want as their guardians.

Invalid Input
6. Tell us about the people you want to provide for in your estate plan.
[For example, you should consider such things as the name of the beneficiaries,
the property or share you want to go to the beneficiaries, what you want done with the gift if a beneficiary
is a minor at the time of your death, or what you want done with the gift if the person named is dead but may have left children]. *

Invalid Input
7. If you are interested in a trust for your family, tell us about your plan.
[For example, what property you want to include in the trust; whether you want the trust to go into effect now
or at your death; who you want to be your trustee(s); and when and how you want the trust property distributed]. *

Invalid Input
8. Tell us a little about your property.
[We are more concerned here with your estimate of the total size of your estate, including joint property and life insurance;
if your estate is very large, special planning may be needed to reduce taxes. Also, if some or all of your property is
jointly owned or in trust, the will drafter must know about it if your plan is to leave that property to someone else in your will.] *

Invalid Input
9. Tell us if you are interested in a "Durable Family Power of Attorney".
[A "Durable Family Power of Attorney" gives another person the power to act directly for you and in your stead; it grants the person
the full authority to bind you and your property. It is not a power that should be lightly granted.
We'll need the name of the person to whom you wish to give the power of attorney and the person's family relationship to you]. *

Invalid Input
10. Tell us if you are interested in a "Living Will".
[A "Living Will" is a document which gives your instructions to your doctors when
extraordinary measures could be used to artificially prolong the process of dying]. *

Invalid Input
11. If you have any directions for your funeral, outline them for us. *

Invalid Input
Please type the following: *
Please type the following:   Refresh
Invalid Input