Estate Planning Questionnaire

Your Name (as it appears on your ID) *

List any alternate names or maiden names

How would you like your name to appear on legal documents? *

How do you like being addressed in conversation? *

What are your preferred pronouns? *

Home Address (include city, state, and zip) *

Email *

Phone Number *

Citizenship *

Date of Birth *

Marital Status *

If applicable, name of spouse (as it appears on ID)

Are you seeking joint representation? *

What are your spouse's preferred pronouns? *

Is this a first marriage? *

Spouse's email address

Spouse's phone number

Do you have children? *

If you have children, list their names and ages *

Are these your biological children? *

Are any of these children adopted? *

Do any of your children have special needs or receive government services or benefits? *

Is there anything else we should know about your children?

For any minor child, who do you want to name as GUARDIAN? (Provide name, relationship, email, phone number, and address) *

For any minor child, who do you want to name as ALTERNATE GUARDIAN? (Provide name, relationship, email, phone number, and address)

Are there any special family issues?

What type of work do you do? *

Do you own or participate in a closely held business? *

Estimate the size of your estate *

About how much of your estate is in Real Estate?

About how much Life Insurance do you have on your life?

About how much of your estate is in 401Ks, IRAs, and similar retirement accounts?

In your own words, describe in detail what should happen to your assets at your death. *

Name a contingent charity or beneficiary of your estate

Who do you want to name as EXECUTOR of your Estate? (Provide name, relationship, email, phone number, and address) *

Who do you want to name as ALTERNATE EXECUTOR of your Estate? (Provide name, relationship, email, phone number, and address) *

Who should act as your HEALTH CARE REPRESENTATIVE to speak with medical providers on your behalf? (Provide name, relationship, email, phone number, and address) - Name One Person *

Who should act as your ALTERNATE HEALTH CARE REPRESENTATIVE to speak with medical providers on your behalf? (Provide name, relationship, email, phone number, and address) - Name One Person *

Do you want to be buried, cremated, or something else? *

Do you want to be an organ donor? *

For the purpose of addressing health care issues, do you follow any religious laws or doctrines? *

Is there anything else we should know about your healthcare wishes? *

Is there anything else you'd like to tell us? *

What is your timeframe and budget? *

How did you hear about us? *

If you participate in a legal plan, provide your membership ID or elligibility ID *

Did someone assist you in the completion of this form? *

If yes, identify the person that helped you complete this form?

TYPE YOUR NAME IF YOU AGREE TO THE BELOW DISCLAIMER *

DISCLAIMER. By submitting this form, you understand and agree that: (a) completion of this form does not create an attorney–client relationship; (b) the Law Office of Robert Aufseeser LLC may review and rely on the information you provide solely to evaluate a potential engagement and, if later agreed in writing, to provide legal services; and (c) the firm’s review is not legal advice. Please do not include confidential or time-sensitive details. Do not rely on this submission to meet any deadlines.

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