Probate Intake Questionnaire

PROBATE INTAKE QUESTIONNAIRE

CONFIDENTIALITY: The information you provide will not be disclosed to anyone who is not directly affiliated with this matter in the course of rendering legal services on your behalf, or otherwise provided by law. Please complete ALL of the sections that apply to the decedent’s family members and assets held in the decedent’s name alone or in joint names with another. The accuracy of this information, along with copies of all supporting documentation, will help with my review of the complexity of this estate prior to our conversation regarding the retention of my services to assist you with the settlement of this estate by drafting and filing the documents required to complete the estate settlement process

Who can I thank for your referral:

Are you seeking an attorney on behalf of someone else? (i.e. parents, brother, sister)

Yes

No

who:

Your relationship to Decedent:

Your name (as shown on your photo ID)

Date of Birth

MM slash DD slash YYYY

Email

Current Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Home Telephone

Cell Phone

DECEDENT:

Name

Address

Date of Birth

MM slash DD slash YYYY

Date of Death:

MM slash DD slash YYYY

SSN

Marital Status

Single

Married

Divorced

Separated

Life Partner

Name of Spouse or Life Partner (even if deceased)

Name of Ex-Spouse

Is he or she still alive?

Yes

No

Date of Divorce or Spouse’s Death

Place of Death (hospital; location, etc.)

IF DECEDENT HAD A LAST WILL & TESTAMENT

Beneficiaries Named in the Will

Name	Email	Actions

There are no Entries.

Maximum number of entries reached.

If a Beneficiary is Deceased, list Deceased Beneficiaries’ Spouse & Children (if any)

Name	Email	Actions

There are no Entries.

Maximum number of entries reached.

IF DECEDENT DIED “INTESTATE” NOT HAVING A LAST WILL & TESTAMENT

ALL of Decedent’s Surviving Children

Name	Email	Actions

There are no Entries.

Maximum number of entries reached.

ALL of Decedent’s Surviving Children

ALL of Decedent’s Deceased Children

Name

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Date of Birth

MM slash DD slash YYYY

Date of Death

MM slash DD slash YYYY

Marital Status

Married

Single

Divorced

Separated

Life Partner

Name of Spouse

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Name of Deceased Child’s Children

Date of Birth

MM slash DD slash YYYY

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

If NO Surviving Spouse or Children, please provide the following

Decedent’s Parents: mother

Father

Address ( if living )

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

IF DECEDENT DID NOT HAVE A SPOUSE OR NEVER HAD CHILDREN

ALL of Decedent’s Siblings

ALL Children of Decedent’s Deceased Siblings

PERSONAL REPRESENTATIVE(S):
Who will be serving as Executor (if there is a Will) or Administrator (if there is no Will)

ASSETS HELD IN DECEDENT’S NAME AT DEATH

BANK ACCOUNTS

Name of Bank

Estimated Balance

Type of Account

Title on Accounts

Business Interests:

Jewelry, Antiques or Collectibles:

Mortgages or Accounts Receivable:

Real Estate Holdings:

Retirement Accounts: IRA, Pensions, Annuities

Securities:

Trusts Interests:

Vehicles: