1. Do you currently have a will? £ Yes £ No
2. Have you been: £ Married £ Divorced £ Had a Child since you wrote your last will?
3. Do you know who the beneficiaries are on your insurance policies, bank accounts and brokerage accounts? £ Yes £ No
4. You will need to name a personal representative, who would you trust to wind up your affairs? Please list an alternative.
___________________________ ___________________________
5. Are there any items that you would like to leave to someone special?
6. Do you have any reason to believe your estate would be contested? £ Yes £ No
7. Do you have any special funeral instructions?
8. Do you prefer: £ Burial £ Cremation
9. Please list your beneficiaries:
Children, Grandchildren, Great Grandchildren
Parents
Siblings
10. Do you have disability insurance? £ Yes £ No
11. Have you ever considered what would happen if you became disabled? £ Yes £ No
12. Who would you want to take care of your children?
13. Who would you want to take care of your finances?
14. Who would make decisions regarding your health care?
15. Do you have a Living Will? £ Yes £ No
16. What is the estimated value of your assets?
17. Are you familiar with a “Living Trust”? £ Yes £ No
18. Please list any charities to which you plan to leave a gift.
19. Is anyone related to you currently receiving Social Security benefits, Medicaid benefits or disability benefits? £ Yes £ No

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Isaksen Law Firm
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