PROBATE & ESTATE ADMINISTRATION QUESTIONNAIRE

Please fill out the form below.

CLIENT INFORMATION:

Full Name

Date of Birth

Street Address

Address Line 2

City

State/Province/Region

ZIP/Postal Code

Country

Home Phone

Work Phone

Cell Phone

Email Address

Are you the named or proposed Personal Representative?

If no, skip to the next step. If yes, please answer the following questions:

Do you have any disabilities that would prevent you from serving as Personal Representative? If yes, please explain:

Have you ever been convicted of a felony? If yes, please explain:

PROPOSED PERSONAL REPRESENTATIVE INFORMATION:

If you are not the proposed Personal Representative, or if a Co-Personal Representative has been named, please provide their information below. If you are the named or proposed Personal Representative, then skip to the next step.

Full Name

Date of birth

Street Address

Address Line 2

City

State/Province/Region

ZIP/Postal Code

Country

Home Phone

Work Phone

Cell Phone

SSN

U.S. Citizen?

Does the proposed/co-personal representative have any disabilities that would prevent them from serving as Personal Representative? If yes, please provide explain:

Has the proposed or co-personal representative you ever been convicted of a felony? If yes, please explain:

SUCCESSOR PERSONAL REPRESENTATIVE INFORMATION

Full Name

Date of birth

Street Address

Address Line 2

City

State/Province/Region

ZIP/Postal Code

Country

Home Phone

Work Phone

Cell Phone

SSN

U.S. Citizen?

Does the successor personal representative have any disabilities that would prevent them from serving as Personal Representative? If yes, please provide explain:

Has the successor personal representative you ever been convicted of a felony? If yes, please explain:

DECEDENT INFORMATION

Full Name

Street Address

Address Line 2

City

State/Province/Region

ZIP/Postal Code

Country

Date of birth

Date of death

SSN

Date of location of Will, if any

Date of location of Codicil, if any

Was the decedent on Medicaid?

BENEFICIARIES OR HEIRS AT LAW

Please include all beneficiaries including the proposed Personal Representative or Successor Personal Representative. If the decedent died without a will, please provide the names of all children of the decedent. If the decedent did not have any children, please provide the names of the decedent’s parents and/or siblings if living.
If you need to add more children, please do so in the notes section at the end of this form.

Decedent's Spouse

Full Name

Street Address

Address Line 2

City

State/Province/Region

ZIP/Postal Code

Country

Home Phone

Mobile Phone

SSN

Decedent's Children

Child (1) Full Name:

Date of birth, if Minor

SSN

Street Address

Address Line 2

City

State/Province/Region

ZIP/Postal Code

Country

Telephone

Work Phone

Cell

Was this child from a previous marriage?

REGISTERED AGENT:

First Name

Last Name

SSN

Street Address

Address Line 2

City

State/Province/Region

ZIP/Postal Code

Country

Telephone

Fax

Cell

Stock/Value of property for LLC

Incorporator/Organizing Member

Business of the corporation/LLC

Where business services will be performed (cities, states)

BUSINESS ADVISOR #1

First Name

Last Name

Company

Capacity

Phone Number

BUSINESS ADVISOR #2

First Name

Last Name

Company

Capacity

Phone Number

BUSINESS ADVISOR #3

First Name

Last Name

Company

Capacity

Phone Number

Please upload any available documents for review:

Any agreements to be used in the business
List of business assets
Deeds to any real property used in the business
Prior tax return if business was operated before LLC
Prior tax return of principal officer/member
Description of business activity
Description of number and type of employees
Copies of any licenses obtained for business