Estate Planning

CLIENT QUESTIONNAIRE

Part One: Client Personal Information

  • Thank you for trusting Four Pillars Law Firm to review your personal information. This information is confidential, and will be used to help our attorneys assess your legal planning needs. Please provide information that is as accurate and complete as possible so we may be able to offer our best legal advice concerning your situation.
  • Spouse

 

Part Two: Children & Family Information

  • Child 2

  • Child 3

  • Child 4

  • Other Relevant Notes Concerning Potential Heirs

 

Part Three: Financial Information

    ASSETS

    Cash, CDs & Bank Accts

  • Stock, Bond & Mutual Fund

  • Annuities (non-qualified)

  • Notes & Accounts Receivable

  • Residence

  • Other Real Estate

  • Life Insurance (cash value)

  • IRA, 401(k)

  • Other Qualified Plan / Account

  • Other

  • Subtotals

  • LIABILITIES

    Real Estate Mortgages

  • Insurance Policy Loans

  • Other Loans and Notes

  • Taxes

  • Other

  • Subtotal

  • LIFE INSURANCE

    Box 1 LIFE INSURANCE

  • Box 2 LIFE INSURANCE

  • Box 3 LIFE INSURANCE

  • Box 4 LIFE INSURANCE

  • IRA & RETIREMENT BENEFIT PLANS

    Box 1 IRA & RETIREMENT BENEFIT PLANS

  • Box 2 IRA & RETIREMENT BENEFIT PLANS

  • Box 3 IRA & RETIREMENT BENEFIT PLANS

  • Box 4 IRA & RETIREMENT BENEFIT PLANS

  • ANNUITIES

    Box 1 ANNUITIES

  • Box 2 ANNUITIES

  • Box 3 ANNUITIES

  • HEALTH INSURANCE

    Box 1 HEALTH INSURANCE

  • Box 2 HEALTH INSURANCE

  • Box 3 HEALTH INSURANCE

  • Box 4 HEALTH INSURANCE

  • OTHER INTERESTS & CONSIDERATIONS

    BUSINESS:

  • PRENEED:

  • TRUSTS:

  • MISCELLANEOUS:

  • EXPENSES:

  • TRANSFERS:

 

Part Four: Goals & Planning

    ADVISORS:

  • LEGAL DOCUMENTS:

 

Part Five: Background Information

 

Part Six: Information Certification

  • I certify the statements and information provided on this questionnaire are true and accurate to the best of my knowledge and belief, after conducting a thorough inquiry. I understand any inaccuracies and/or omissions in the information provided may substantially impact the appropriateness of any recommended planning, which may result in the need for contracting additional and/or revised planning.
  • Section

  • Contact Information for Person Completing the Questionnaire, if not the Prospective Client:
  • Section

 

Verification

Comments are closed.