Last Will And Testament Questionnaire printable pdf download

LAST WILL AND TESTAMENT QUESTIONNAIRE

Privacy Act Notice: AUTHORITY: 10 U.S.C. § 8012, EO 9397; PRINCIPAL PURPOSE: To collect data on you to assist your lawyer in

drafting your will. It will not be disseminated outside the legal office and is considered confidential. ROUTINE USES: See principal purpose;

DISCLOSURE IS VOLUNTARY: You are not required to complete this form; however, your failure to do so may mean the legal office cannot

provide you with a will.

After completing this form, call (937) 257-6142 to schedule an appointment with an attorney. If you need more

space, attach a piece of paper with the additional information. Date of appointment:_________________________

Personal Data:

1. Full Name:_____________________________________________________________Male____/Female____

First

Middle Name

Last

Address:_____________________________________________________________________________________

Are you a U.S. Citizen? ___Yes ___No

May your attorney email you a draft copy of your will for your review ? ___Y___N (If yes, please provide email)

___________________________________________________________________________________________

Do your assets, including Life Insurance, total more than $500,000? ___Y___N

Do your assets, including Life Insurance, total more than $1,000,000? ___Y___N

Note: If your assets, including life insurance policies, now exceed or are soon expected to exceed $1,000,000, you may advised to

discuss your estate-planning options with a civilian attorney who specializes in that field.

This is the state listed on your leave and earning statement (LES).

2. State of Legal Residence: ________________________ .

3. Military Status: ____Active/____Retiree/____Dependent/____Guard/Reserve

4. Marital Status: ___single/___married/___divorced/___pending divorce/___divorced & remarried/___widow(er)

If married, spouse’s full name: ________________________________ Is spouse a U.S. Citizen? ___Yes ___No

Were you previously married? ______Yes ______No

5. Children: Do you have children? __Y__N If yes, use the following codes to indicate status of children: N=natural;

S=stepchild; A=adopted. Do you wish to treat adopted/stepchildren the same as natural children? __Y__N

FULL NAME (Including full middle name)

Sex

Age

Status

___________________________________________________________________________________________

Spouse and Child Beneficiaries:

6. If married, do you want all of your real estate and personal property to go to your spouse?

____yes ____no

7. If you are not married or your spouse does not survive you, do you want all of your real estate and personal

property to go to your children? ____yes ____no

8. If any child is under the age of 18, at what age do you want them to receive their share of the estate: ______

9. Do you want to give your Executor to have control/discretion on when and how to distribute a minor child’s

inheritance? ___ Yes ___ No

By answering no, you may create a Trust that can have additional requirements and expenses.

10. If no, who do you wish to exercise that control? _________________________ Relationship: _________________

11. If any of your children do not survive you, do you want his or her potential share of your inheritance to pass to

his or her children (your grandchildren)?

____yes ____no

Last Will And Testament Questionnaire

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