BASIC ESTATE PLANNING BOOT CAMP ISBA Trusts & Estates Section 20 S. Clark Street Suite 900 Chicago, IL April 25, 2013

Transcription

1 BASIC ESTATE PLANNING BOOT CAMP ISBA Trusts & Estates Section 20 S. Clark Street Suite 900 Chicago, IL April 25, 2013 A Country Lawyer s Approach To Information Gathering Presented By: Paul A. Meints, Esq., CLU, ChFC 2 Kenyon Court Bloomington, IL Telephone: 309-TAX-1040 [ ] meintstaxlaw@frontier.com Copyright by Paul A. Meints 2013 [Liberal permission given to each attendee to use in his/her practice] 1

2 Table of Contents Forms & Data Gathering Aids Page: 3 Questionnaire for the Parents of Minor Children 15 Estate Organizer With Farm Related Provisions 26 Non-Statutory Power of Attorney for Property & Health Care 41 Power of Attorney for temporary care of minors 46 Advance Medical Directives 58 Temporary Beneficiary Designation for Parents of Minor Children 2

3 PAUL A. MEINTS Attorney - CLU ChFC Please Reply to: 108 S.W. Arch Street - Box 310 #2 Kenyon Court Atlanta, IL Telephone: Bloomington, IL TAX-1040 [ ] meintstaxlaw@frontier.com Fax: MINOR CHILDREN'S TRUST & ESTATE PLANNING QUESTIONNAIRE A. Parental Information: 1. Name of FATHER: Social Security #: Born: / /19 Resides at: Address: Employed by: Telephone # at Home: Mobile Phone Number(s): Names of Father's Living Parents: at Work: Names of Father's Living Brother(s) and Sister(s): Are any inheritance(s) anticipated? [ ] Yes [ ] No When? Approx. Value: $ 2. Name of MOTHER: Maiden: Social Security #: Born: / /19 Resides at: Address: Employed by: Telephone # at Home: Mobile Phone Number(s): Names of Mother's Living Parents: at Work: Names of Mother's Living Brother(s) and Sister(s): Are any inheritance(s) anticipated? [ ] Yes [ ] No When? Approx. Value: $ B. Information Concerning Children: 1) 2) Full Name Date of Birth Address: Copyright 2013 Paul A. Meints Law Office 3

4 3) 4) 1. Do any of the children have mental or health related impairments/disabilities? [ ] Yes [ ] No If Yes, please request my outline on Estate Planning for the Parents of Handicapped Children and briefly describe the child s handicap here: 2. Are any of the children from a prior marriage? [ ] Yes [ ] No If yes, indicate on the last page of this questionnaire by (a) which parent, (b) whether they have been or intend to be legally adopted by the new spouse, (c) if they are in the custody of another person, (d) provide the name and address of the other parent, (e) describe your relationship with the parent, and (f) describe your relationship with the child s grandparents, etc. 3. If any children are adopted by you or by your children at some point in the future, shall the adopted child share equally with the natural (biological) children? [ ] Yes [ ] No [ ] Not Sure [ ] Open for Suggestions 4. Do you have any special wishes or requests concerning the raising and development of your children? E.g., raised in the Catholic faith; attend religious school(s); encourage participation in sports; visitation with grandparents and other close relatives encouraged, etc. C. Information Concerning Disposition of Personal Property: 1. Are personal effects and household goods to pass to the surviving spouse? [ ] Yes [ ] No If not, to whom? 2. At the death of the surviving spouse, are personal effects and household goods to pass to the surviving children? [ ] Yes [ ] No If not, then to whom? D. Information Concerning Specific Bequests: 1. Do you wish any individual or entity to receive property at the first death or at the survivor's death? E.g., Church, parent, etc. [ ] Yes [ ] No If so, what, when and to whom? 2. Do you (i) have income such as renewals and commissions that could be paid after your death or (ii) now own or plan to ac- 4

5 quire (a) property in another state and/or outside of the United States, (b) closely-held business interest(s) [businesses with a limited number of owners], (c) tax shelters, or (d) items of an unusual nature? Describe: E. Information Concerning Disposition of Remaining Property: 1. Do you want the balance of the estate to pass to the surviving spouse? [ ] Yes [ ] No [ ] Not Sure 2. Would you like money or property to be left to one or more CHARITIES? At the first death? Survivor s estate? Specific Amount? Percentage? Donor Advised Fund? Your wishes: 3. Upon the death of the surviving spouse, is the balance of the estate to pass into the Children's Trust? [ ] Yes [ ] No [ ] Not Sure 4. At what age(s) should the child(ren) be for the outright receipt of his or her share of the estate? _ Would you consider staggered distributions, e.g., 25, balance at age 30, having "act" together for 5 years income paid annually until trust ends? Providing incentives and rewards? [ ] Yes [ ] No [ ] Not Sure [Use asset protection planning ] 5. If both of your estates are liquidated, converted to cash, all life insurance and retirement benefits received, and all debts and mortgages paid, APPROXIMATELY HOW MUCH REMAINS FOR YOUR CHIL- DREN? $ (Please provide a good faith estimate) (Do you now have (i) an umbrella liability policy with limits that exceed this value? [ ] Yes [ ] No, (ii) auto and homeowner liability limits that exceed this value? [ ] Yes [ ] No [Bring Policy Declaration [statement of liability coverages] for your home and also for your auto with you when we meet]). If the primary wage earner died tomorrow approximately how much income would the surviving spouse and family need in the year that follows in order to continue the family s current standard of living? $ /Year for years. Approximately how much do you now owe to others (mortgages, car loans, credit cards, student loans, etc.) $ 6. If your children die (a) before you do (car accident, for example) or (b) prior to their receiving all of their property (the age selected for the final distribution from the Children s Trust) where would you like your property to go? (Example: 1/2 to Husband's relatives and 1/2 to Wife's relatives; to charity; etc.) F. Information Concerning Fiduciaries : 5

6 1. Who do you want to serve as EXECUTOR [Settles the estate pays the bills takes court action, if necessary]? a. First Choice: Address: Telephone #: home: Work: Mobile Phone Number(s): b. Second Choice: Telephone #: home: Work: Mobile Phone Number(s): c. Third Choice: Address: Telephone #: home: Work: Mobile Phone Number(s): [Note: I try very VERY hard to avoid Co-executors, coagents, and the like Sharing this job is not practical and not terribly efficient. Normally the Executor also serves as your agent for any power of attorney] 2. Who do you want to serve as GUARDIAN of your children's PROPERTY (also as the TRUSTEE(S) for the Children's/ Handicapped Child s Trust)? a. First Choice: Address: Telephone #: home: Work: Mobile Phone Number(s): b. Second Choice: Address: Telephone #: home: Work: Mobile Phone Number(s): c. Third Choice: Address: Telephone #: home: Work: Mobile Phone Number(s): 3. Who do you want to serve as GUARDIAN of your children's PERSON (provide day-to-day care/nurturing)? a. First Choice: Address: Telephone #: home: Work: Mobile Phone Number(s): b. Second Choice: Address: Telephone #: home: Work: Mobile Phone Number(s): c. Third Choice: Address: Telephone #: home: Work: Mobile Phone Number(s): 6

7 G. Names and Addresses of any INSURANCE COMPANY or Provider of RETIREMENT BENEFITS. (Please insert policy loans in the margin). Account/ Insured Policy Name Address Policy #: H/W Amount 1) [City, State, Zip] 2) [City, State, Zip] 3) [City, State, Zip] 4) [City, State, Zip] 5) [City, State, Zip] 6) [City, State, Zip] H. Additional Estate Planning Related Documents, Concepts, and Planning Issues: 1. Durable General Power of Attorney for PROPERTY: Assists in smooth management of property related matters in the event of your illness, injury, incapacity, disability, or absence. A MUST!! 2. Durable Power of Attorney for HEALTH CARE: Assists in obtaining good services and quality medical care if your health deteriorates. (I combine with #1 for fewer overall documents and direct access to the checking account). Often one of the first documents asked for by a hospital. Needs to expressly deal with the release of medical information [HIPAA medical privacy protected health information (PHI)]. Pre-printed fill-in-the blank / statutory / short-form power forms commonly available date back to September of 1987 [minor updates effective January 1, 2012] and can easily be improved upon. A MUST!! Helpful, too, for any child over age 18. Many colleges will not release any information, even serious medical issues, to a parent without something in writing from the student. 3. Power of Attorney for Minor's Care: Assists in obtaining medical services for a minor child should the parent(s) be absent. A MUST for nearly all families having minor children. Designating someone to help with the child s longer-term education and raising is done with different paperwork. In September of 2007 the designated time frame went from 60 days to 365 days. I normally 7

8 address these issues based on an as needed basis, most often triggered because of being a single parent with declining health issues. 4. Living Will: Helps avoid artificially sustained life support when there is essentially no hope of recovery. Husband: [ ] Yes [ ] No Wife: [ ] Yes [ ] No (Does not seem to be essential IF (i) Health Care Power of Attorney and (ii) Advance Medical Directives, items #2 and #5, exist). 5. Advance Medical Directives: Gives the person who is responsible for actually making medical decisions greater information, specificity, and insight as to your specific health care related decisions, wishes, and objectives. Often confused with a living will. Keeps your personal wishes and situation from being covered by national TV and the news media and reduces much of the stress on the person who has the unfortunate responsibility for making these difficult end-of-life decisions. Religious beliefs can be incorporated but only with some difficulty and with additional issues raised. Please remind me if you wish to incorporate faith based beliefs into this document. A MUST FOR NEARLY EVERY- ONE, including any living parent(s) of yours. 6. Organ & Tissue Donations: Noting your wishes on your Driver's License is a simple, inexpensive, and helpful way to carry out special wishes concerning donation of your (i) body, (ii) organs, and/or (iii) tissue/skin. In the past this was done by signing on the back of your driver s license. Now days it is coded on the front of your license. Adding this to your Will is not practical. Noting your desire to be cremated in your will is also not practical. Separate card and registration with the Secretary of State or other organization are used by some individuals to note their wishes. Registration for the new Illinois First-Person Consent Organ & Tissue Donor Registry is done easiest at a driver s license facility rather than on-line. If you wish to donate your organs then another close family member/friend should also be informed of your wishes. Reminders about this should also be included with your Health Care Power of Attorney and any Advance Medical Directives which you complete. A very very serious shortage of donors exists. Not without controversy, however. 7. Emergency Contact Database Registration. The Illinois Secretary of State has developed a wonderful program for helping people make emergency contact with selected family members or friends designated emergency contact. Anyone wishing to utilize this service should start by going to the Illinois Secretary of State s website: Look for Emergency Contact Database someplace on home page, click, and follow the instructions. A maximum of two names and telephone numbers can be added. Highly suggested for your parents and other single family members if they spend time in an automobile. 8. Final Wishes Form: A simplified way to let someone know your wishes for the funeral. Difficult to discuss with others. 8

9 The funeral industries pre-paid arrangements are having some difficulties. Until those issues are resolved I m not in favor of pre-paying for any funeral-like arrangements. 9. Spousal Consent Form: Generally required when completing new retirement benefit beneficiary designations of any kind company pension plan, 401(k), IRA s of all types. Some difficulty may be encountered if you are under 35. Also, there is not universal recognition among retirement plan providers of what rules actually apply to what. 10. Life Insurance Beneficiary Designation Change Form: A new beneficiary designation is nearly always required to coordinate the payment of life insurance proceeds with the overall estate plan. Same is true for any retirement related plans and benefits, perhaps even commissions, renewals and other income which may be paid after death. (An irrevocable life insurance trust is helpful for some families having (a) potential estate tax issues [generally for estates that exceed $5,250,000 [2013] in value] and (b) significant amounts of life insurance, most often limited to only term life insurance for families having young children). NEVER NEVER NEVER EVER NAME MINOR CHILDREN AS A BENEFICIARY FOR INSURANCE OR RETIREMENT BENEFITS, not primary not secondary not anything. [Please ask me for a temporary beneficiary designation if you anticipate that you will not complete your new estate plan in the near future]. This beneficiary designation concept can also be helpful when dealing with renewals, commissions, overrides, unpaid salary, and other income which is owed and payable after the earner's death called income in respect of a decedent ( IRD ) under Section 691 of the Internal Revenue Service Tax Code. 11. Joint Tenancy Personal Property Declaration: Helps establish title to assets normally having no generally recognized title. Minimizes probate expenses and unintended heirs of such. Does not seem to be essential for persons whose income comes from salary associated with working for another entity or person. Helpful for some second/third marriage situations - for farmers and small business owners -- helpful in dealing with the lack of ownership/title to such items as machinery, livestock, chemicals, prepaids, growing crops, tools and equipment, tenant matters, inventory, office equipment, receivables, and the like these being the most common examples that come up. Some form of recognition/ declaration is also helpful in second marriage/blended family situations involving children from a prior marriage. 12. Revocable Living Trust (Inter Vivos Trust): MAY minimize probate expenses, shorten time before distribution, reduce public disclosure or personal affairs, and provide some protection during lifetime. Having a revocable trust done correctly is more expensive than a will with trust provisions - final cost depending upon (i) the complexity of the estate plan and the number of the documents needed and (ii) the funding of the trust. Using a Revocable Living Trust as the basic document requires a serious long-term post-signing client commitment to and through the time of death for 9

10 greatest benefit. Revocable Living Trusts are NOT everyone's estate planning answer!!! It is my belief that revocable living trusts are generally better suited for (i) older adults (sixty and over), (ii) persons who own real estate outside the state of their domicile, and/or (iii) those who have been convinced revocable trusts are the answer by going to an estate planning seminar - second/third/fourth marriages (at any age) being another area where they are often useful. Common Law trusts and Offshore planning almost always benefit the seller of the services more than you. Trusts provided by your insurance agent or financial adviser should be avoided. Irrevocable trusts should be limited to only life insurance, preferably term insurance, and here only if some ability to be flexible in the future exists within the document. Residential and Charitable trusts are seldom beneficial for persons with young children. Stay away from lettered trusts : DAPTS, CLATS, CLUTS, GRATS, GRUTS, DIGITS, etc. Avoid free or almost-free estate planning from LegalZoom, Oprah, and others on TV. 13. Wrongful Death Settlement Election: Wrongful death litigation may involve a large sum which can cause problems if not considered ahead of time. Rarely happens but, when it does, there are often large dollar amounts involved. Generally left to you to decide if you want to deal with this. Typically adds approximately one hour of time to try and deal with this issue. Husband: [ ] Yes [ ] No [ ] Not Sure Wife: [ ] Yes [ ] No [ ] Not Sure 14. Tenancy By The Entirety for Your Residence. It is now possible in Illinois to provide additional creditor protection ( asset protection being another term that I use from time to time) for your home through use of tenancy by the entirety rather than joint tenants with rights of survivorship ownership. Tenancy by the entirety is the same as joint tenancy but with additional creditor/asset protection [total protection versus $15,000 homestead protection for joint tenancy] and is my standard /preferred form of ownership for the marital residence. Typically adds slightly less than one hour to address this change. Find your deed and see what form of ownership you currently have. Cost of recording this new deed is approximately $51.00 in most counties. Average legal fees are around $100 for the deed preparation. Advisable to request lender's permission before completing and recording the new deed. [ ] Yes [ ] No [ ] Already have it 15. Asset Protection Planning. This simply means keeping your property out of the hands of people you or your heirs don t think should have it. Filing a law suit ranks as the perceived second quickest way to get rich ahead of inheritance and behind winning the lottery. In the business world, corporations and LLC s (limited, if any, asset protection for the one-man LLC) are common asset protection devices, big estates often go offshore, domestic asset protection trusts [DAPTs] now permitted in a handful of states. I like Family Limited Liability Limited Partnerships (FLLLP), permitted in Illinois since about It is my belief that the philosophy of some people to sue everyone for anything will continue through my lifetime and yours if you own it, it can 10

11 be taken away. Problems can arise simply from a person, old or young, being in the wrong place at the wrong time, poor selection of spouses/ friends/acquaintances, failure to have adequate liability insurance coverage to cover judgments, etc. I like asset protection planning! Asset protection plans and strategies range from being very simple ( cheap ) to very complex (mucho expensive), tenants by the entirety being an example of a very simple but highly effective approach. [Often more important for your parents as their estate is typically larger than yours]. Related issues involve [ ] an umbrella liability policy for personal matters, [ ] appropriate liability limits/umbrella policy for any business, [ ] protecting property and business with a corporation, limited liability company (LLC), limited partnership, LLLP, etc. Very very rare for me to create a business entity in another state, e.g., Delaware, Nevada, Texas, Alaska, Iowa. If you own or share ownership in a business then these issues need to be discussed and made a part of your overall estate plan buy-sell agreement/ business continuation planning covering (i) death, (ii) disagreement, (iii) deadlock, (iv) divorce, (v) disability, etc. [ ] Yes [ ] No [ ] Already have it [ ] Maybe let s talk. 16. Conflict of Interest Matters. It is generally easiest (and cheapest) for one attorney to help both the husband and the wife develop a common family estate plan. Marital relationships, however, can change over time. Happy couples can become very unhappy couples. Couples who agree today may disagree in the future. Sometimes these changes are minor. Sometimes they are or become major and serious. The general rule in Illinois is for each person to have his and her own attorney. This may be helpful in some respects but not in other respects. Two approaches are common among lawyers, either (i) tell nothing or (ii) tell everything. My practice is to keep no secrets, information being shared with both parties. Please check the appropriate box as to whether or not you want one attorney to help you with your estate planning matters. Husband: [ ] Yes [ ] No [ ] Not Sure Wife: [ ] Yes [ ] No [ ] Not Sure For more than thirty-nine years my policy on client confidentiality has been, is, and will remain pretty simple: nothing gets shared with others unless you tell me to do so. 17. Family Related Issues. Some families have very good relationships. Other families do not. Some families have unique circumstances, some do not. Most families have a little bit of both. Do any difficulties exist which may cause potential problems in the future? Husband: [ ] Yes [ ] No [ ] Not Sure Wife: [ ] Yes [ ] No [ ] Not Sure 18. Estate & Gift Tax Laws for 2013 and Later. On January 2, 2013, President Obama extended the 2012 estate exemption of $5,120,000 to 2013 and future years, the amount now being indexed for inflation. The estate and gift tax free amount for Illinois is $4,000,000 with no automatic increase now being in place. Annual 2012 gifting of $13,000 has risen to $14,000 per person in While you may not need a lot of tax planning, please remember that the need for people protection and property protection occurs 11

12 at all levels of wealth. Wealth redistribution was one of the essential differences in the 2012 Presidential election makers versus the takers, the takers now out numbering the makers in Illinois. 19. Liability Coverages for Auto and Home; Umbrella Policy. Please request a current print-out from your insurance agent of the details concerning your auto and homeowner s insurance. When you do this give him or her written permission to talk directly to me. BRING THE PRINT-OUT(S) TO OUR MEETING. It is crucial that you have realistic liability limits. Having low amounts involved helps the insurance company s profitability but may complicate your life in the event of a serious accident. Remember that accidents are not always the other person s fault. Judgments last for 10 years and can be renewed indefinitely to take advantage of greater future income, inheritances, good fortune, and the like. 20. Other: I. My Estate Planning Philosophy and Fees for Services: My fees for estate planning are based on the amount of time involved. Nothing more and nothing less. [See Item J for approximating this cost]. It is my goal to provide a flexible, comprehensive, quality, timely, professional service that meets your needs now and in the future. I will not sacrifice quality to match advertisements or another firm's price nor will I do work which is not consistent with my personal standards for doing the best work that I know how to. A copy of my professional resume is available upon request. J. ESTIMATE of Total Fees for Estate Plan: 1. Meeting(s) and discussion(s) -- hour(s) (Varies from client to client); 2. Tax analysis, calculations, recommendations, and preparation of alternative approaches for saving estate taxes: hours (generally not done if the need to save taxes is not perceived by all parties to be an important issue - $5,250,000, indexed for inflation, is exempt from federal death tax for 2013 and futures years nothing is permanent as long as Congress is in session - and $4,000,000, not indexed, is exempt from Illinois death tax beginning The odds of a permanent total estate tax repeal movement has slowed considerably with substantial tax deficits or shortages that exist at both the federal and the state levels, remember that significant amounts are needed to pay the interest, pay for increasing governmental services and regulations, business bail-outs, high salaries, health care for everyone, extended unemployment benefits, the war effort, natural disasters, Medicaid, etc.; 12

13 3. Drafting of Documents - hours; 4. Re-drafting of documents - hours (generally unknown at the time of the first meeting); 5. Preparation and organization for signing of documents -- hour(s) (one hour is most common); 6. Normal Signing of Documents -- hour(s) a little over one hour is most common for typical families witnesses need to know you reasonably well generally signed at a location of your choice to make your supplying of two witnesses easier for everyone if you have a dysfunctional family then think about having three witnesses; 7. Post-signing Matters - changing ownerships and/or beneficiary designations, new deed for tenancy by the entirety's creditor protection, dealing with service providers, insurance companies, and retirement benefit providers are the most common examples of this -- hour(s) (actual amount of time for this is never known until the job is done); 8. Travel Time Billing varies according to the circumstances typically no charge for short distances. 9. s and Telephone Calls typically no charge if short and relatively infrequent. 10. Other matters known now: -- hours 11. ESTIMATED time for items 1 through 10: hours 12. Current hourly rate: $ /Hour 13. Estimated Photocopying Expenses -- $ 14. Other Expenses $ Estimated Total for items 11 14: $ We hereby acknowledge that (i) we have had the opportunity to ask questions concerning our estate and its distribution and (ii) we wish Paul A. Meints to proceed with the implementation of an estate plan for each of us. We further acknowledge that our estate planning needs change over time and that it is our responsibility to monitor and periodically evaluate our current estate plan, scheduling reviews with the attorney of our choice no less often than once every five (5) years. We also understand that some documents, such as powers of attorney for property or health care, become less effective over time ( stale ) and that best acceptance occurs when the documents are fresh, less than five years old sixty (60) days for most powers of attorney dealing with stocks, bonds, and securities, 120 days for some dealings with the IRS, some hospitals now wanting nothing older than one year. We understand the manner in which Paul will calculate his fees for the work he does. We agree to promptly pay for any work done, whether or not we finally sign such. If Paul's bill is not paid within thirty (30) days after his statement is provided to us then interest shall accrue at the rate of one percent per month until Paul's bill has been paid in full. If such charges are not fully paid within ninety (90) days then we will pay any legal expenses and other costs of collecting the amount(s) outstanding. We further promise that neither of us will make any copies of the documents he gives us, sign the documents without his knowl- 13

14 edge, nor will we share or provide such information to other person(s) without Paul's written consent. Dated:, 201 Dated:, 201 Father - Signature Mother - Signature Member of: McLean County, Logan County, Illinois, Indiana, and American Bar Associations since Licensed to Practice before the Indiana, Illinois, and United States Supreme Court, Federal District Court, and the United States Tax Court since Selected by peers in 1996 to be among the first twenty-five (25) lawyers in Illinois to be designated as a "Leading Illinois Attorney" in (1) Trusts and Estate Planning, (2) Agricultural Law, (3) Agricultural and Natural Resources (Real Estate), and (4) Individual Income Tax. Chairperson of the Agricultural Law Section Council of the Illinois State Bar Association for

15 Information Needed Please Bring: [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] Latest 1040 and Any Business Income Tax Return [1041/1065/1120/1120-S] including the depreciation schedules/worksheet/breakdown/summary utilized in calculating taxes; Deed for each parcel/legal Descriptions (From Deed, Mortgage, or Title Commitment) Real Estate Tax Bill(s) Existing Wills/Trusts/Estate Planning Documents Business Entity Papers, Record Books, and Agreements (Corp./LLC/FLP/FLLLP, etc.) Declaration of liability insurance coverages, options, and limits for auto-home-farmbusiness insurance [also bring a photocopy of all vehicle titles] Names, addresses, and telephone numbers for close family members (Children, Parents, brothers, sisters [close friends if there are no close family members]) Describe pending/potential inheritances Names, addresses, and telephone numbers of trusted financial advisers Information and documents for loan(s) to children; current outstanding balance(s) Choice for Person to be Agent for Medical and Property Power of Attorney*: 1) Spouse 2) 3) 4) * Include names, addresses, and telephone numbers (home, work, and mobile/cell) FAMILY ESTATE PLANNING ORGANIZER FAMILY INFORMATION Date, Name of FATHER/CLIENT: Social Security #: Born: / /19 Resides at: Address: Employed by: at Telephone # at Home: Mobile Phone Number: Names of Father's Living Parents: Work: Names of Father's Living Brother(s) and Sister(s): Are any inheritance(s) anticipated? [ ] Yes [ ] No When? Approx. Value: $ Date of this Marriage: / / Any prior marriage(s)? [ ] Yes / No [ ] 2. Name of MOTHER/CLIENT: Maiden: Social Security #: Born: / /19 Resides at: 15

16 Address: Employed by: at Telephone # at Home: Mobile Phone Number: Names of Father's Living Parents: Work: Names of Father's Living Brother(s) and Sister(s): Are any inheritance(s) anticipated? [ ] Yes [ ] No When? Approx. Value: $ Any prior marriage(s)? [ ] Yes / No [ ] Any outstanding obligations by either party? CHILDREN** (if married give married names note any children with multiple marriages) 1. Name: Spouse s Name: Address: Telephone #: home: Work: Mobile Phone Number: Birthdate: Grandchildren: 2. Name: Spouse s Name: Address: Telephone #: home: Work: Mobile Phone Number: Birthdate: Grandchildren: 3. Name: Spouse s Name: Address: Telephone #: home: Work: Mobile Phone Number: Birthdate: Grandchildren: 4. Name: Spouse s Name: Address: Telephone #: home: Work: Mobile Phone Number: Birthdate: Grandchildren: 5. Name: Spouse s Name: Address: Telephone #: home: Work: Mobile Phone Number: Birthdate: Grandchildren: Are any children or grandchildren handicapped? Under Financial Stress? Drugs or alcohol? Marital Difficulties? [ ] Yes [describe at the end] [ ] No Are any of the children from a prior marriage? [ ] Yes [ ] No Do any of your children/child s spouse have difficulty managing money? [ ] Yes [ ] No ** If you have no children please list/describe the persons, charities, or friends you wish to leave property to. 16

17 ASSETS SCHEDULE A LIQUID FUNDS 1. Checking Accounts or Money Market Funds Name of Institution In Whose Name(s) Ave. Amt. $ In Whose Name(s) Ave. Amt. $ In Whose Name(s) Ave. Amt. $ In Whose Name(s) Ave. Amt. $ 2. Savings, Certificates of Deposit, and similar interest-bearing investments Name of Institution In Whose Name(s) Ave. Amt. $ In Whose Name(s) Ave. Amt. $ In Whose Name(s) Ave. Amt. $ In Whose Name(s) Ave. Amt. $ In Whose Name(s) Ave. Amt. $ TOTAL $ SCHEDULE B -- U.S. SAVINGS BONDS, TREASURY BILLS, or AGENCY BONDS Type Maturity Date Owner(s)* Maturity Value TOTAL $ *Names of owners should be taken from the face of the stocks and notes. Show such language as and/or to indicate how title is held. [If you don t have access to the latest software on US Savings bond values, then it is helpful to just make a copy of the bonds and bring with you. Individual values can be found by going to If multiple bonds are involved the US Savings Bond Wizard is a better choice: Also suggested that you have a photocopy of the bonds at another location. SCHEDULE C -- CORPORATE or MUNICIPAL BONDS or BOND FUNDS Face Amount Issuer Owner(s)* Amount Paid 17

18 TOTAL $ SCHEDULE D STOCKS or STOCK MUTUAL FUNDS # of Shares Company Common or Owner(s)* Current Fair Preferred Market Value $ $ $ $ $ $ $ $ TOTAL $ SCHEDULE E NOTES AND MORTGAGES HELD FOR LOANS YOU MADE TO OTHERS Name of Person Name of Person the Original Current in Debt to You Note Is Made Out To* Date Due Amount Balance Due $ $ $ $ $ $ TOTAL $ SCHEDULE F RETIREMENT ACCOUNTS [Pension, Profit Sharing, HR-10, IRA, ROTH, 401(k), 457, 419, Etc.] Type of Account Name on Primary Current Account Held By/With Account Number Account Beneficiary* Value $ $ $ $ * Most beneficiary designations now require social security numbers and birth dates of the beneficiaries, even secondary. SCHEDULE G AUTOMOBILES, TRUCKS, BOATS, OR RECREATIONAL VEHICLES 1. Make & Year Registered owner(s) 2. Make & Year Registered owner(s) 3. Make & Year Registered owner(s) 4. Make & Year Registered owner(s) Any missing titles? [ ] Yes / [ ] No TOTAL $ [Bring Declaration of Liability Coverages with you] SCHEDULE H MAJOR HOUSEHOLD GOODS, ANTIQUES, & SPECIAL COLLECTIONS 18

19 Brief Description: TOTAL $ SCHEDULE I RESIDENTIAL - URBAN - VACATION - INVESTMENT REAL ESTATE Parcel 1. Legal Description: County State Owned in name(s) of If more than one owner, please indicate how title is held: [ ] Joint Tenancy (right of survivorship) [ ] Tenancy in Common [ ] Tenants by the Entirety [ ] Trust [ ] Unknown Date of acquisition How acquired: [ ] Gift [ ] Purchase [ ] Inheritance Mortgage With Current Mortgage Balance: $ Price paid or value when acquired $ PRESENT VALUE $ [Bring Homeowner s Summary of Liability Coverages with you] Parcel 2. Legal Description: County State Owned in name(s) of If more than one owner, please indicate how title is held: [ ] Joint Tenancy (right of survivorship) [ ] Tenancy in Common [ ] Tenants by the Entirety [ ] Trust [ ] Unknown Date of acquisition How acquired: [ ] Gift [ ] Purchase [ ] Inheritance Mortgage With Current Mortgage Balance: $ Price paid or value when acquired $ PRESENT VALUE $ TOTAL VALUE OF ALL PARCELS $ FARM SCHEDULE (if applicable) SCHEDULE J FARM MACHINERY and EQUIPMENT* Brief Description: * Bring Farmowner s Policy/Farm Net Worth Statement TOTAL VALUE $ SCHEDULE K LIVESTOCK Kind and Number: TOTAL VALUE $ SCHEDULE L GRAIN INVENTORY [Field (Growing)/Bins/Elevator/Futures] 19

20 Kind and Amount: TOTAL VALUE $ SCHEDULE M FARM REAL ESTATE Tract 1. Farm Known as: No. of Acres: Tillable Acres: Section: Township: County: USDA No. Real Estate Tax No. (PIN): Owned in name(s) of If more than one owner, please indicate how title is held: [ ] Joint Tenancy (right of survivorship) [ ] Tenancy in Common [ ] Tenants by the Entirety [ ] Trust [ ] Unknown Date of acquisition How acquired: [ ] Gift [ ] Purchase [ ] Inheritance Current Lender/Mortgagor: Balance Remaining: $ Describe Lease Terms: Price paid or value when acquired $ PRESENT VALUE $ Tract 2. Farm Known as: No. of Acres: Tillable Acres: Section: Township: County: USDA No. Real Estate Tax No. (PIN): Owned in name(s) of If more than one owner, please indicate how title is held: [ ] Joint Tenancy (right of survivorship) [ ] Tenancy in Common [ ] Tenants by the Entirety [ ] Trust [ ] Unknown Date of acquisition How acquired: [ ] Gift [ ] Purchase [ ] Inheritance Current Lender/Mortgagor: Balance Remaining: $ Describe Lease Terms: Price paid or value when acquired $ PRESENT VALUE $ Tract 3. Farm Known as: No. of Acres: Tillable Acres: Section: Township: County: USDA No. Real Estate Tax No. (PIN): Owned in name(s) of If more than one owner, please indicate how title is held: [ ] Joint Tenancy (right of survivorship) [ ] Tenancy in Common [ ] Tenants by the Entirety [ ] Trust [ ] Unknown Date of acquisition How acquired: [ ] Gift [ ] Purchase [ ] Inheritance Current Lender/Mortgagor: Balance Remaining: $ Describe Lease Terms: Price paid or value when acquired $ PRESENT VALUE $ Tract 4. Farm Known as: No. of Acres: Tillable Acres: Section: Township: County: USDA No. Real Estate Tax No. (PIN): Owned in name(s) of If more than one owner, please indicate how title is held: [ ] Joint Tenancy (right of survivorship) [ ] Tenancy in Common [ ] Tenants by the Entirety [ ] Trust [ ] Unknown Date of acquisition How acquired: [ ] Gift [ ] Purchase [ ] Inheritance Current Lender/Mortgagor: Balance Remaining: $ Describe Lease Terms: Price paid or value when acquired $ PRESENT VALUE $ 20