ESTATE PLAN CLIENT WORKBOOK

Transcription

1 ESTATE PLAN CLIENT WORKBOOK When completing these pages, you do NOT have to relist any items that you feel are already in the hands of GCD /1/03500/94608

2 I. CLIENT PERSONAL DATA First Name Middle Initial Last Name _ Social Security No. Citizen Yes No Birth Date Place of Birth Home Address City & State _ Zip Code County of Residence Telephone: Residence ( ) Business ( ) Fax: ( ) II. SPOUSE PERSONAL DATA First Name Middle Initial Last Name (If different than spouse's) Social Security No. Business ( ) Birth Date Place of Birth Citizen Yes No III. CHILDREN DATA Please use complete names Date of Name Birth Spouse's Name Address (City & State) - 2 -

3 IV. GRANDCHILDREN Name Parent Age V. TRUSTEES AND SUCCESSOR TRUSTEES Trustee: Co-Trustees: Co-Trustee(s): a) b) c) d) Address (city and state) if other than child - 3 -

4 Successor Trustee(s): a) b) c) d) Address (city and state) if other than child VI. EXECUTOR If client is first to die: Executor: Co-Executor: Successor Executors: 1) 2) If spouse is first to die: Executor: Co-Executor: Successor Executors: 1) 2) VII. GUARDIAN Guardian: Successor Guardian: VIII. ALLOCATION Joint Beneficiary Designation(or Client's Designation, if separate allocation desired) Desired Primary Beneficiaries:(Check appropriate category) All children of both spouses (equally) (Preferred Choice) Only named children (equally) (used if you wish to exclude one or more children) - 4 -

5 Other people (or institutions) or unequal allocations Names of Primary Beneficiaries (if not all children) or names and percentages if not equal _ Spouse's Beneficiary Designation (DO NOT COMPLETE IF SAME AS SPOUSE) Desired Primary Beneficiaries:(Check appropriate category) All children of both spouses (equally) (Preferred Choice) Only named children (equally) (used if you wish to exclude one or more children) Other people (or institutions) or unequal allocations Names of Primary Beneficiaries (if not all children) or names and percentages if not equal IX. DISTRIBUTION FOLLOWING DEATH OF CLIENT AND SPOUSE The most common types of distribution are (check one): Assets distributed outright Assets distributed when Beneficiary(s) is age Income only (assets are retained in trust) Deferred right of withdrawal 1/3 outright 1/3 at age 1/3 five years later 1/3 at age 1/3 ten years later 1/3 at age Other (specify) _ - 5 -

6 IX. POWERS OF ATTORNEY - IDENTIFY AGENTS HEALTH CARE AGENT FOR CLIENT Agent* : First Successor* : Second Successor* : HEALTH CARE AGENT FOR SPOUSE Agent* : First Successor* : Second Successor* : PROPERTY AGENT FOR CLIENT Agent* : First Successor* : Second Successor* : PROPERTY AGENT FOR SPOUSE Agent* : First Successor* : Second Successor* : * - identify relationship of person to you as well - 6 -

7 XI. FINANCIAL ANALYSIS Client Date Joint CASH & CASH EQUIVALENTS Husband Wife Tenancy Checking Account Certificates of Deposit Treasury Bills Credit Union Money Market Savings Account Other Total $ $ $ $ $ $ MARKETABLE SECURITIES Stocks Bonds (Govt/Corp) Bonds (Municipal) Mutual Funds (Stock) Mutual Funds (Bond) Annuities Gold & Silver Other Total $ $ $ $ $ $ - 7 -

8 REAL ESTATE Husband Wife Joint Tenancy NON-MARKETABLE INVESTMENT Joint (Partnership Interests, etc.) Husband Wife Tenancy $ $ $ LIFE INSURANCE - INSURING HUSBAND'S LIFE Company Number Insurance Value Owner Beneficiary _ LIFE INSURANCE - INSURING WIFE'S LIFE Company Number Insurance Value Owner Beneficiary - 8 -

9 CLOSELY HELD BUSINESS INFORMATION Are you the owner of a closely-held business Yes No If yes, please complete the following: Name of business Address of business Is the business a: (check one) sole proprietorship general partnership limited partnership "C" Corporation "S" Corporation Describe your ownership interest_ If there is more than one owner, does a buy-sell agreement exist among the owners? Yes No If yes, when was the buy-sell agreement last reviewed RETIREMENT PLANS Husband Wife IRA's $ $ Keogh Pension/Profit Sharing Plan Total before life insurance $ $ - 9 -