Questionnaire: Probate

Probate Intake Form

CLIENT DETAILS

Client's Full Name(Required)

First Middle Last

Client's Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Client's Telephone Number(Required)

Client's Email Address(Required)

Enter Email Confirm Email

Relationship To Decedent(Required)

DECEDENT DETAILS

Address of the Decedent(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Date of Birth of the Decedent(Required)

Date of Death of the Decedent(Required)

Social Security Number of the Decedent

Did the Decedent have a Will?(Required)

Yes

I do not know

Location of Will(Required)

Date of Will(Required)

Was the Decedent survived by a spouse?(Required)

Yes

SPOUSE DETAILS

Name of the Spouse(Required)

First Last

Address of the Spouse(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Date of Birth of the Spouse

Social Security Number of the Spouse

WILL PERSONAL REPRESENTATIVE / EXECUTOR DETAILS

Name of the Personal Representative/Executor of the Will(Required)

Prefix First Last

Address of the PR/Executor

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Telephone Number of the PR/Executor(Required)

Email of the PR/Executor(Required)

Enter Email Confirm Email

Relationship to the Decedent(Required)

Alternate Name of the Personal Representative / Executor of the Will

Prefix First Last

Address of the Alternate PR/Executor

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Telephone Number of the Alternate PR/Executor

Email of the Alternate PR/Executor

Enter Email Confirm Email

Relationship to the Decedent

Did the Decedent have Children?(Required)

Yes

I do not know

CHILDREN DETAILS

List Children Below (For additional Children click the ( + ) button.

Name

Date of Birth

SSN

Address

City

State

Zip

Telephone

* TO ADD ADDITIONAL CHILDREN, CLICK THE (+) ON THE RIGHT SIDE OF THE "EMAIL" FIELD.

Do you need to list Other Beneficiaries?(Required)

Yes

I do not know

OTHER BENEFICIARIES

List Other Beneficiaries Below (For additional beneficiaries click the ( + ) button.

Name

Date of Birth

Relationship to Decedent

Address

City

State

Zip

Telephone

* TO ADD OTHER BENEFICIARIES, CLICK THE (+) ON THE RIGHT SIDE OF THE "EMAIL" FIELD.

ASSETS

Safe Deposit Box?(Required)

Yes

I do not know

Location of the Safe Deposit Box(Required)

REAL ESTATE

List Details of Real Estate Below (For additional properties click the ( + ) button.

Address

City

State

Zip

What County

Approx. Value (if known)

How Titled

Homestead (Type Yes or No)

* TO ADD MORE REAL ESTATE, CLICK THE (+) ON THE RIGHT SIDE OF THE "HOMESTEAD" FIELD.

Any Stocks/Bonds?(Required)

Yes

I do not know

STOCKS AND BONDS

List Details of Stocks/Bonds Below (For additional stocks/bonds click the ( + ) button.

Name of Company

Type of Security

How Titled

Location of Certificate

Date of Death Value

* TO ADD MORE, CLICK THE (+) ON THE RIGHT SIDE OF THE "DATE OF DEATH VALUE" FIELD.

Are you aware of any Bank Accounts?(Required)

Yes

I do not know

BANK ACCOUNTS

List Details of Bank Accounts Below (For additional accounts click the ( + ) button.

Bank Name

Account Number

Name on Account

Amount/Value of Account

* TO ADD MORE ACCOUNTS, CLICK THE (+) ON THE RIGHT SIDE OF THE "AMOUNT/VALUE OF ACCOUNT" FIELD.

Are you aware of any Money Market Accounts or Certificates of Deposit?(Required)

Yes

I do not know

MONEY MARKET ACCOUNTS / CERTIFICATES OF DEPOSIT

List Details of Money Market Accounts/Certificates of Deposit Below (For additional accounts click the ( + ) button.

Name of Institution

Account Number

Name on Account

Amount/Value of Account

* TO ADD MORE ACCOUNTS, CLICK THE (+) ON THE RIGHT SIDE OF THE "AMOUNT/VALUE OF ACCOUNT" FIELD.

Are you aware of U.S. Government Savings Bonds (E, EE, H)?(Required)

Yes

I do not know

U.S. GOVERNMENT SAVINGS BONDS

List Details of U.S. Government Savings Bonds Below (For additional Bonds click the ( + ) button.

How Titled

Location of Bonds

To Be Cashed? (Yes or No)

If "Yes", Name of Transferee

Amount/Value

* TO ADD MORE ACCOUNTS, CLICK THE (+) ON THE RIGHT SIDE OF THE "AMOUNT/VALUE" FIELD.

Are you aware of any Mortgages and Notes (Receivable)?(Required)

Yes

I do not know

MORTGAGES AND NOTES (RECEIVABLE)

List Details of Mortgages/Notes Below (For additional mortgages click the ( + ) button.

Mortgagor

Address

City

State

Zip

Terms of Obligation

Amount/Value

* TO ADD ADDITIONAL MORTGAGES, CLICK THE (+) ON THE RIGHT SIDE OF THE "AMOUNT/VALUE" FIELD.

Are you aware of any Insurance Policies (Life or otherwise)?(Required)

Yes

I do not know

INSURANCE POLICIES

List Details of Insurance Policies Below (For additional policies click the ( + ) button.

Company Name

Policy #

Beneficiaries Named

Location of Policy

Amount/Value

* TO ADD ADDITIONAL POLICIES, CLICK THE (+) ON THE RIGHT SIDE OF THE "AMOUNT/VALUE" FIELD.

Are you aware of any Annuities?(Required)

Yes

I do not know

ANNUITIES

List Details of Annuities Below (For additional policies click the ( + ) button.

Company Name

Policy #

Beneficiary Named

Location of Policy

Amount/Value

* TO ADD ADDITIONAL POLICIES, CLICK THE (+) ON THE RIGHT SIDE OF THE "AMOUNT/VALUE" FIELD.

Are you aware of any Vehicles?(Required)

Yes

I do not know

PERSONAL PROPERTY (VEHICLES)

List Details of Vehicles Below (For additional items click the ( + ) button.

Make

Model

Year

VIN # (if available)

Location of Title

Approx. Amount/Value

* TO ADD ADDITIONAL VEHICLES, CLICK THE (+) ON THE RIGHT SIDE OF THE "APPROX. AMOUNT/VALUE" FIELD.

Are you aware of any Personal Property (Miscellaneous)?(Required)

Yes

I do not know

PERSONAL PROPERTY (MISCELLANEOUS)

List Details of Personal Property Below (For additional items click the ( + ) button.

Item

Description

Location of Item

Approx. Amount/Value

* TO ADD ADDITIONAL ITEMS, CLICK THE (+) ON THE RIGHT SIDE OF THE "APPROX. AMOUNT/VALUE" FIELD.

DOCUMENTS

Which documents are you able to provide?

DEATH CERTIFICATE

PAID FUNERAL BILL

REAL ESTATE DEEDS

VEHICLE TITLES

COPIES OF BILLS

ADDRESSES OF CREDITORS

LAST WILL AND TESTAMENT