Living Trust Information Form (Short Form) Page 4

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Miscellaneous
Are you a legally appointed guardian? Yes ____ No ____. If yes, please explain:
____________________________________________________________________________________________________________
Have you been appointed under a power of attorney? Yes ____ No ____. If yes, please explain:
____________________________________________________________________________________________________________
Do you currently serve as executor or administrator of an estate? Yes ____ No ____. If yes, please explain:
____________________________________________________________________________________________________________
Are you involved in a lawsuit? Yes ____ No ____. If yes, please explain:
____________________________________________________________________________________________________________
DISTRIBUTION OF YOUR ESTATE:
Special gifts of Personal Property
Before your estate is distributed, will there be any special gifts of personal property made? Yes ____ No ____. If yes,
Recipient of gift
Description of gift
Pay at death of :
________________________
______________________________________
[ ]Single Settlor [ ]Surviving Spouse
[ ]Husband [ ]Wife
________________________
______________________________________
[ ]Single Settlor [ ]Surviving Spouse
[ ]Husband [ ]Wife
________________________
______________________________________
[ ]Single Settlor [ ]Surviving Spouse
[ ]Husband [ ]Wife
_______________________
______________________________________
[ ]Single Settlor [ ]Surviving Spouse
[ ]Husband [ ]Wife
Special cash gifts
Before your estate is distributed, will there be any special cash gifts made? Yes ____ No ____. If yes,
Recipient of cash gift
Amount of cash gift
Pay at death of :
________________________
______________________________________
[ ]Single Settlor [ ]Surviving Spouse
[ ]Husband [ ]Wife
________________________
______________________________________
[ ]Single Settlor [ ]Surviving Spouse
[ ]Husband [ ]Wife
________________________
______________________________________
[ ]Single Settlor [ ]Surviving Spouse
[ ]Husband [ ]Wife
_______________________
______________________________________
[ ]Single Settlor [ ]Surviving Spouse
[ ]Husband [ ]Wife
4

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