Will Intake Form printable pdf download

WILL INTAKE FORM

MANGANO LAW OFFICES CO., LPA

PLEASE READ. Except for specific bequests (see below), your entire estate will go to your spouse, or to

your children, if your spouse predeceases you under this simple will. If you are interested in this

arrangement, then please complete this form. If you are not interested in this arrangement, then STOP and

contact Mangano Law Offices at (216) 397-5844 for additional services. If you want to finalize your Will at

Local 423’s Will Clinic, please return this form prior to the Will Clinic. You may fill out this form at the Will

Clinic, but your Will may not be completed until later. The date of the Will Clinic will be announced soon.

PLEASE ANSWER ALL QUESTIONS

1. Member Information

a. Full Name___________________________________________________________________

b. Address_____________________________________________________________________

c. Phone No._______________________________ Cell Number_________________________

d. Marital status Married_________Single___________

2. Spouse’s Information

a. Full Name___________________________________________________________________

b. Address Sames as above____ Other______________________________________________

**If you are not married, please list beneficiary(ies)_______________________________________

_______________________________________________________________________________

3. Marital Information

a. Have you ever divorced? Yes_____ No______

4. Dependents

a. Names ______________________________________________________________________

b. Ages ________________________________________________________________________

c. If your children are minors, please state the name and address of the individual(s) you would like to

recommend for guardianship.________________________________________________________

d. If one of your children or beneficiary (ies) predeceases you, do you want his or her share of your estate

to go to your other children/beneficiary _____or to her children _________.?

5. Other Wills

Do you currently have a will? Yes________ No________. If yes, please bring a copy to the Will Clinic.

6. Specific Bequests

Do you want to make any specific bequests? (Example: I bequest my wedding ring to my niece, Sally

Jones.)

Item

Full Name of Person

_____________________________

Will Intake Form