Estate Questionnaire - Law Offices of Thomas P. Miller, P.C.
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Today's Date
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Which of the following do you authorize us to send you the following by e-mail
I. Your Information
Full name
E-mail
Telephone number
Home address
Date of birth
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Your spouse's full name
II. Heirs and Beneficiaries
You must list all your children (heirs) and all people you want to receive under your Will (beneficiaries).
Child 1: Name
Date of birth
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Address
Child 2: Name
Date of birth
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Address
Child 3: Name
Date of birth
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Address
Child 4: Name
Date of birth
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Address
Other Person You Want to Provide For 1: Name
Date of birth
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Relationship to you
Address
Other Person You Want to Provide For 2: Name
Date of birth
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Relationship to you
Address
III. Executors
An executor will make sure that what your will states is done. A successor acts if the executor cannot or does not want to act.
Executor Name
The executor must administer the Will for the beneficiaries' benefit.
Executor Address
Successor Executor Name
Successor Executor Address
IV. Guardian of Minor Children (if any)
A guardian is someone that you want to care for your children if you and the child's other parent are gone.
First Choice: Name
First Choice: Address
Second Choice: Name
Second Choice: Address
V. Children's Trust
Do you want a Children's Trust
Until what age do you want the trust to be effective?
Trustee: Name
The trustee will control the distribution of the money for the child's benefit.
Trustee: Address
Successor Trustee: Name
Successor Trustee: Address
VI. Additional Information Bequests
List any specific directions. These may include specific items you want to go to specific beneficiaries, or you can list heirs (such as children) that you do not want to inherit anything.
VII. Power of Attorney - Healthcare
This person will make healthcare decisions for you whenever you cannot.
Event or date that you want the Power of Attorney for Healthcare to become effective
First Choice for POA: Name
First Choice for POA: Address
Second Choice for POA: Name
Second Choice for POA: Address
VIII. Power of Attorney - Property
This person will make financial decisions for you whenever you cannot.
Event or date that you want the Power of Attorney for Healthcare to become effective
First Choice for POA: Name
First Choice for POA: Address
Second Choice for POA: Name
Second Choice for POA: Address
IX. Miscellaneous
How did you find us? Please provide name of person who referred you or website.
If you need more space to  answer any of the above  questions, please use this  space.
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