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1 THE RICE LAW FIRM, PLLC Fax: (281) ESTATE PLANNING QUESTIONNAIRE FOR MARRIED COUPLE If you are interested in preparation of wills only, please fill out Parts I IV of the following questionnaire. If you are also interested in preparation of other Estate Planning such as Financial or Medical Power of Attorneys, Directive to Physicians, or Guardians in the Event Need Arises, then please fill out Parts V(a) and (b) as well. Please print neatly. If you need more space, please attach another sheet. Once you have completed this form, please fax or to the contact information above. Upon reviewing your answers, the Estate Planning Attorney will contact you to set up a consultation. 1. Your full name: a. Phone number: b. address: 2. Spouse s Name: a. Phone number: b. address: PART I PERSONAL DATA 3. Marital History a. If currently married, state date of marriage? i. Name the children of this marriage: ii. b. If either of you has been previously married, please state the following (include any who are deceased? i. Him 1. Name of ex-spouse and date of Divorce or name of deceased spouse and date of death? 2. Names of children from previous marriage and their birthdates? Page 1 of 10

2 ii. Her 1. Name of ex-spouse and date of Divorce or name of deceased spouse and date of death? 2. Names of children from previous marriage and their birthdates? c. State names and birthdates of Grandchildren including their parents names? 4. Do you presently have a will? a. If yes, what is the date on that Will? b. Was it signed in Texas? c. If not where was it signed? 5. Does spouse presently have a will? a. If yes, what is the date on that Will? b. Was it signed in Texas? c. If not where was it signed? PART II YOUR DISPOSITIVE PLAN 6. Describe in general terms how you wish to distribute your property under your will: a. Husband: b. Wife: Page 2 of 10

3 7. The Wills should set up simple trusts for minor children grandchildren who might inherit under your wills. At what age do you want those trusts to terminate at which point the assets will be distributed outright to the children: PART III(a) ASSETS FOR YOU AND YOUR SPOUSE 8. Please describe the approximate value of your assets as of the date of completing this questionnaire. Add another sheet if necessary. (Note: The transfer of certain assets at death results from agreements created during lifetime. Those assets cannot be transferred or distributed according to the terms of the will unless the beneficiary designated in the Agreement is the estate. Those assets are called not-testamentary assets and some of them are: life insurances, POD accounts, JTWROS accounts, trusts, etc.) a. Value of Cash and Accounts: i. Include the total value of cash, traveler s checks, money orders, and accounts with commercial banks, savings banks, credit unions, etc. b. Value of Real Estate: i. Include the total value of any real property on which you or your spouse are an owner, joint owner or have an interest in any manner, including property purchased in recreational developments and time-shares. c. Value of Mineral Interests: i. Include the total value of any property in which the parties own the mineral estate, separate and apart from the surface estate, such as oil and gas leases; also include royalty interests, working interests, and producing and non-producing oil and gas wells. d. Value of Brokerage/Mutual Fund Accounts: e. Value of Stocks, Bonds and other Securities: i. Include securities not in a brokerage account, mutual funds or retirement fund. f. Value of Closely Held Business Interests: i. Include value of sole proprietorships, professional practices, corporations, partnerships, limited liability companies and partnerships, joint ventures, and other non-public traded business entities g. Value of Business Personal Property: Page 3 of 10

4 i. Patents, copyrights, trademarks, and royalties, etc. h. Value of Retirement Benefits: i. Including Defined Contribution Plans, Defined Benefit Plans, IRA s, etc. Also include Government Benefits such as civil service, teacher, railroad, state and local, etc. ii. State the name and relationship of Primary Beneficiary: i. Value of all Life insurances: i. State the name and relationship of Primary Beneficiary: j. Value of all Motor Vehicles, Boats, Airplanes, Cycles, etc (include mobile homes, trailers, and recreational vehicles). k. Value of other miscellaneous property: i. (Include household furniture, furnishings, and fixtures, electronics and computers, artwork, collections, sporting goods, firearms, jewelry, livestock, etc.) l. Value of any Anticipated Inheritance: m. Value of items in Safe Deposit Boxes: PART III(b) LIABILITIES FOR YOU AND YOUR SPOUSE 9. Please describe your liabilities as of the date of completing this questionnaire. Add another sheet if necessary. a. Outstanding mortgages on all of your real estate: b. Total of your car notes: c. Consumer and business debts: d. Other significant loans and debts: PART IV(a) YOUR DESIGNEES 10. Who do you wish to be the primary executor/executrix of your estate? This is the person who will be responsible for probating your will, filing the estate tax return (if your estate is taxable) and distributing assets to the beneficiaries. Married persons commonly appoint their spouses as primary executor. Please identify only one person. Page 4 of 10

5 11. Who do you wish to be an alternate executor/executrix of your estate? Please identify only one person. 12. If either the primary or the alternate executor/executrix lives out-of-state, name a person who lives in Texas to receive service of process. Please identify only one person. 13. Do you want your executor/executrix to function independently of the court? (If the answer is yes, the executor will carry out your wishes without asking the court s approval for every step taken. This may reduce the administrative and legal expenses). a. YES b. NO 14. Do you want your executor/executrix to function without posting a bond? (If your answer is yes, your executor will carry out your wishes without leaving money with the court. This may reduce administrative and legal expenses). a. YES b. NO b. 15. Who do you wish to appoint as Guardian and Trustee for your minor children. (If you have minor children and both parents die before the minor children reach 18, a guardian and a trustee should be appointed to take care of them and the money they will inherit. The guardian and trustee are often the same person). a. Primary: i. Name and Relationship: i. Name and Relationship i. Name and Relationship: PART IV(b) SPOUSE S DESIGNEES Page 5 of 10

6 16. Who do you wish to be the primary executor/executrix of your estate? This is the person who will be responsible for probating your will, filing the estate tax return (if your estate is taxable) and distributing assets to the beneficiaries. Married persons commonly appoint their spouses as primary executor. Please identify only one person. 17. Who do you wish to be an alternate executor/executrix of your estate? Please identify only one person. 18. If either the primary or the alternate executor/executrix lives out-of-state, name a person who lives in Texas to receive service of process. Please identify only one person. 19. Do you want your executor/executrix to function independently of the court? (If the answer is yes, the executor will carry out your wishes without asking the court s approval for every step taken. This may reduce the administrative and legal expenses). a. YES b. NO 20. Do you want your executor/executrix to function without posting a bond? (If your answer is yes, your executor will carry out your wishes without leaving money with the court. This may reduce administrative and legal expenses). a. YES b. NO 21. Who do you wish to appoint as Guardian and Trustee for your minor children. (If you have minor children and both parents die before the minor children reach 18, a guardian and a trustee should be appointed to take care of them and the money they will inherit. The guardian and trustee are often the same person). a. Primary: i. Name and Relationship: i. Name and Relationship Page 6 of 10

7 i. Name and Relationship: Fill out this part of the questionnaire only if you are interested in preparation of other Estate Planning such as Financial or Medical Power of Attorneys, Directive to Physicians, or Guardians in the Event Need Arises. PART V(a) OTHER ESTATE PLANNING FOR YOU 22. Who do you want to appoint as your primary Durable Power of Attorney (i.e. the person who will be responsible for handling your financial affairs in the event you become incapacitated. a. Name of Power of Attorney: 23. Who do you want to appoint as your alternate Durable Power of Attorney? a. Name of Power of Attorney: 24. Who do you want to appoint as your primary agent for medical care power of attorney? (i.e. who will make your medical decisions for you in the event you are unable to make them for yourself?) Please identify only one person. 25. Who do you want to appoint as alternate agent for medical care power of attorney? Please identify only one person. 26. Who would you wish to be your primary guardian of your person? (i.e. the person will take care of your needs, feeding/clothing, make decisions on house placement, etc., should you be declared incapacitated by a court)? Please identify only one person. a. Name of Guardian: Page 7 of 10

8 27. Who do you want to exclude as guardian of your person? (A court will not appoint a person you excluded to be the guardian of your person). i. Relationship to you: 28. Who would you wish to be your primary guardian of your estate? (i.e. the person who will make financial decisions for you, should you be declared incapacitated by a court?) Please identify only one person. a. Name of Guardian: 29. Who do you want to exclude as guardian of your estate? ( A court will not appoint a person you exclude to be the guardian of your estate.) i. Relationship to you: 30. Regarding a Directive to Physicians document, please answer the following questions: a. Do you want life support if death is imminent and life support would only serve to artificially prolong the moment of death? i. YES NO b. Do you want to give your agent for health care any of the following powers? c. To have a feeding tube removed? YES NO d. To have IV removed? YES NO e. To have a breathing machine removed? YES NO PART V(b) OTHER ESTATE PLANNING FOR SPOUSE 31. (Answer this question only if you have minor children) - Who do you want to appoint guardian of your minor children, should both parents die? a. Name of Guardian: 32. Who do you want to appoint as your primary Durable Power of Attorney (i.e. the person who will be responsible for handling your financial affairs in the event you become incapacitated. Page 8 of 10

9 a. Name of Power of Attorney: 33. Who do you want to appoint as your alternate Durable Power of Attorney? a. Name of Power of Attorney: 34. Who do you want to appoint as your primary agent for medical care power of attorney? (i.e. who will make your medical decisions for you in the event you are unable to make them for yourself?) Please identify only one person. 35. Who do you want to appoint as alternate agent for medical care power of attorney? Please identify only one person. 36. Who would you wish to be your primary guardian of your person? (i.e. the person will take care of your needs, feeding/clothing, make decisions on house placement, etc., should you be declared incapacitated by a court? Please identify only one person. a. Name of Guardian: 37. Who do you want to exclude as guardian of your person? (A court will not appoint a person you excluded to be the guardian of your person). i. Relationship to you: 38. Who would you wish to be your primary guardian of your estate? (i.e. the person who will make financial decisions for you, should you be declared incapacitated by a court?) Please identify only one person. a. Name of Guardian: Page 9 of 10

10 39. Who do you want to exclude as guardian of your estate? ( A court will not appoint a person you exclude to be the guardian of your estate.) i. Relationship to you: 40. Regarding a Directive to Physicians document, please answer the following questions: a. Do you want life support if death is imminent and life support would only serve to artificially prolong the moment of death? i. YES NO b. Do you want to give your agent for health care any of the following powers? c. To have a feeding tube removed? YES NO d. To have IV removed? YES NO e. To have a breathing machine removed? YES NO Page 10 of 10

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