Probate & Estate Administration Intake Form

Name :

Please Enter your name

Address :

Please Enter your address

City :

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State :

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Choose OneALAKAZARCACOCTDEDCFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY
Zip :

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Email address :

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Home Phone :

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Business Phone :

Cellular or Pager :

Facsimile :

What does this matter involve?Choose OneProbate of an EstateAdministration of an EstateEstate Planning

Probate / Administration Of An Estate

Name of the decedent :

Date of death :

Residence at the time of death :

Your relationship to the decedent :

Did the decedent leave a will?

Yes No

If yes, do you have a copy of the will?

Yes No

Are you named as the executor or administrator in the will?

Yes No

If no, who is named?

What was the marital status of the decedent?Choose OneSingleMarriedDivorcedSeparatedWidowed
If married or separated, please provide the name and address of the spouse:

Did the decedent have any children?

Yes No
If yes, list their names and addresses. If no, please list the names and addresses of the decedents closest known relatives:

Is there anyone not listed above (including charitable organizations) who is named as a beneficiary of the will, if any?

Yes No
If yes, list their names and addresses:

Please describe any concerns you have about this estate:

Describe what you would like to happen to resolve your concerns (your preferred outcome):

Have other attorneys worked on this matter?

Yes No
If yes, provide names, addresses, and a brief description of their involvement:

Estate Planning

What is your marital status?Choose OneSingleMarriedDivorcedSeparatedWidowed
Please list the names and addresses of your children, if any:

Please list the names and addresses of anyone else (including charitable organizations) you wish to provide for in your estate plan:

Do you now have a will?

Yes No

Life insurance?

Yes No

Retirement plan?

Yes No

Do you own a business?

Yes No
If yes, provide the business name, address, and phone:

If you own a business, how is the business organized (if known)?Choose OneSole ProprietorshipPartnershipLimited Liability Company or PartnershipProfessional CorporationS CorporationC CorporationOther
What is your approximate net worth:

Describe your concerns regarding your estate:

Describe what you would like to happen with your estate (your preferred outcome):

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