Estate Planning Questionnaire — Law Office of Rex Alan Lowe

Progress is saved only if you keep this page open. Nothing is stored on the server until you submit, and then only as an email.

How far you have scrolled

Privacy notice

Information you give while seeking legal advice from this office is covered by the attorney-client privilege (Evidence Code § 954). Answers are used only for your estate plan and file. They are emailed to LAW@REXLOWE.COM and are not written into a database. Do not use this form on a shared computer you do not trust. Submit only on the office’s secure website.

I have read this notice and wish to continue.

About you

Full present name

Full name at birth

Date of birth

U.S. citizen (yes/no)

Telephone

Referred by Marital history (single, married, separated, divorced, widow — include dates and states) Residential address, how long there, and fax if any Business or employer, address, and telephone Other income Primary care physician Social Security number Prior wills, codicils, trusts, and amendments (dates). Please bring copies. Father (name, living or deceased) Mother (name, living or deceased)

Current spouse, if any

Full present name

Date of birth

U.S. citizen

Telephone

Address (or “same”) Employer and other income Social Security number

Children

One child per block. Category: natural, spouse’s child not adopted, or adopted. Use “Add child” for more.

Ages and fiduciaries

Age when the youngest heir should receive Age when each heir should receive Executor — name, address, phone, relationship Alternate executor Bond or insure the executor at estate expense? (yes/no) Trustee Alternate trustee Guardian of children Alternate guardian

Property

List real property, securities, pensions, businesses, insurance, vehicles, and other assets. Note title, date acquired, value, separate property, and loans. If you need more room, continue in the same box.

Approx. husband’s / man’s assets

Approx. wife’s / woman’s assets

Anticipated growth rate

Combined current assets

Property detail

Gifts

Specific items, recipients, and alternates. Say what happens if a recipient dies first. Residuary gifts by percentage (must total 100), recipients, and alternates Disinheritances — name, address, phone, relationship

Final wishes

Funeral arrangements to be made by Disposition of remains (buried or cremated, for each person) Authorize organ donation? (yes/no) Sealed letters to survivors, and where the letters are Instructions not discussed above Vital documents — where wills, deeds, insurance, tax records, and similar papers are kept Financial inventory — assets and liabilities, with values and title (H, W, J, or T)

Verification

Typing your name confirms the information is correct to the best of your knowledge. The office may still ask for a signed original.

Typed name

Date

Second typed name, if any

Date