SECTION 1. GENERAL INFORMATION
DATE: ___________ DOCS REQUESTED :________________________ _____________________________
Marital Status: Married Single Divorced ___ Widowed ____
1. Your Name (First, Middle, Last) Soc. Sec. No. Date of Birth
| | | |
2. Spouse's Name (First, Middle, Last) Soc. Sec. No. Date of Birth (If Applicable)
| | | |
3. Home Address (Number, Street) City State Zip
| | | | |
4. Mailing Address If Different (Number, Street) City State Zip
| | | | |
5. Home Phone
| |
SECTION 2. PERSONAL INFORMATION
(Answer each of the following Questions)
1. Are you a U.S. citizen? YOU ______ YOUR SPOUSE ______
2. Do you have a will or trust now? YOU ______ YOUR SPOUSE ______
3. If you have a current trust, will this be a restatement? _________
4. How many living children do you have? YOU ______ YOUR SPOUSE ______
5. How many deceased children do you have? YOU ______ YOUR SPOUSE ______
6. How many children under age 18 do you have? YOU ______ YOUR SPOUSE ______
SECTION 3. FINANCIAL INFORMATION
1. Do you own a home or any other real estate that you would like to transfer into your trust?
Yes ____ No____
2. Do you have any other titled assets, such as a car, boat or motor home that you would like to