This questionnaire is designed only for
those married individuals who wish to hold interest in a trust jointly.
Please fill out this form as completely as possible. If you don't understand
a question, please email or call us for assistance.
Today's date:
Name of Trust:
Grantor & Trustee Information:
You will be the Grantors and the Trustees of your Trust.
Grantor = the person or entity who places his, her, or its property into
the Trust.
Trustor = the person or entity who manages the Trust and Trust Property.
Please provide us with the following information:
Name of Grantor Husband
Grantor Husband Address: Street
City
State
Zip
Grantor Husband Phone: Home Phone
Cell Phone
Office Phone
ext
Grantor Husband E-Mail:
Do you have a former spouse?
Yes
No
Name of Grantor Wife
Grantor Wife Address: Street
City
State
Zip
Grantor Wife Phone: Home Phone
Cell Phone
Office Phone
ext
Grantor Wife E-Mail:
Do you have a former spouse?
Yes
No
IMPORTANT NOTE: If you can't
finish this questionnaire you may submit as much as you have completed.
You will see this button
at various places along the questionnaire. Simply click it to submit what
you have finished already.
Then, when you have time to complete the questionnaire,
return to this page and simply input your name and email only and continue
on to unanswered sections. We will match up your 2nd, 3rd, etc. submissions
with your 1st by your name and email.
Successor Trustee
Information :
A Successor Trustee is the person who will handle the affairs of your estate
upon the death of both of you. This person or persons should be someone
who is a responsible individual and is willing and able to take on this
responsibility. You may list more than one Successor Trustee and indicate
whether you wish for them to act as co-trustees (i.e.: simultaneous trustees)
or consecutive individual trustees. If you wish for them to be co-trustees,
they must both consent to any and all decisions made.
1. Name of Successor Trustee
Successor Trustee Address: Street
City
State
Zip
This Successor Trustee to Act as
Co-trustee
Act individually (in order listed)
2. Name of Successor Trustee
Successor Trustee Address: Street
City
State
Zip
This Successor Trustee to Act as
Co-trustee
Act individually (in order listed)
3. Name of Successor Trustee
Successor Trustee Address: Street
City
State
Zip
This Successor Trustee to Act as
Co-trustee
Act individually (in order listed)
4. Name of Successor Trustee
Successor Trustee Address: Street
City
State
Zip
This Successor Trustee to Act as
Co-trustee
Act individually (in order listed)
5. Name of Successor Trustee
Successor Trustee Address: Street
City
State
Zip
This Successor Trustee to Act as
Co-trustee
Act individually (in order listed)
Children Information: Please
compete the information below. If you have children from a previous marriage
please include the relationship to each child. Then indicate the % of the
trust estate you wish to distribute to each child in the event of your death.
Also please name the guardian and an alternate guardian you wish to provide
for your minor children in the event of your death.
1. Name of Child
Address: Street
City
State
Zip
Relationship
son to mother
son to father
son to both
daughter to mother
daughter to father
daughter to both
% of estate to distribute to this child:
% Is this child a minor?
Yes
No
If the child is a minor, please indicate who you wish to be their Guardian
and Alternate Guardian in the event of your death: Guardian
My Spouse
Other
If other list Name
Other guardian Address: Street
City
State
Zip
Phone
Alternate Guardian Name
Alternate Guardian Address: Street
City
State
Zip
Phone
2. Name of Child
Address: Street
City
State
Zip
Relationship
son to mother
son to father
son to both
daughter to mother
daughter to father
daughter to both
% of estate to distribute to this child:
% Is this child a minor?
Yes
No
If the child is a minor, please indicate who you wish to be their Guardian
and Alternate Guardian in the event of your death: Guardian
My Spouse
Other
If other list Name
Other guardian Address: Street
City
State
Zip
Phone
Alternate Guardian Name
Alternate Guardian Address: Street
City
State
Zip
Phone
3. Name of Child
Address: Street
City
State
Zip
Relationship
son to mother
son to father
son to both
daughter to mother
daughter to father
daughter to both
% of estate to distribute to this child:
% Is this child a minor?
Yes
No
If the child is a minor, please indicate who you wish to be their Guardian
and Alternate Guardian in the event of your death: Guardian
My Spouse
Other
If other list Name
Other guardian Address: Street
City
State
Zip
Phone
Alternate Guardian Name
Alternate Guardian Address: Street
City
State
Zip
Phone
4. Name of Child
Address: Street
City
State
Zip
Relationship
son to mother
son to father
son to both
daughter to mother
daughter to father
daughter to both
% of estate to distribute to this child:
% Is this child a minor?
Yes
No
If the child is a minor, please indicate who you wish to be their Guardian
and Alternate Guardian in the event of your death: Guardian
My Spouse
Other
If other list Name
Other guardian Address: Street
City
State
Zip
Phone
Alternate Guardian Name
Alternate Guardian Address: Street
City
State
Zip
Phone
5. Name of Child
Address: Street
City
State
Zip
Relationship
son to mother
son to father
son to both
daughter to mother
daughter to father
daughter to both
% of estate to distribute to this child:
% Is this child a minor?
Yes
No
If the child is a minor, please indicate who you wish to be their Guardian
and Alternate Guardian in the event of your death: Guardian
My Spouse
Other
If other list Name
Other guardian Address: Street
City
State
Zip
Phone
Alternate Guardian Name
Alternate Guardian Address: Street
City
State
Zip
Phone
6. Name of Child
Address: Street
City
State
Zip
Relationship
son to mother
son to father
son to both
daughter to mother
daughter to father
daughter to both
% of estate to distribute to this child:
% Is this child a minor?
Yes
No
If the child is a minor, please indicate who you wish to be their Guardian
and Alternate Guardian in the event of your death: Guardian
My Spouse
Other
If other list Name
Other guardian Address: Street
City
State
Zip
Phone
Alternate Guardian Name
Alternate Guardian Address: Street
City
State
Zip
Phone
Beneficiary Information: Please
list any additional beneficiaries you wish to add to your trust. A Beneficiary
is any person or entity that will benefit from the trust by receiving all
or a portion of the trust estate (property) in the event of your death.
Only list the individuals you wish to divide a percentage of your estate
to. You will have the option later to list additional beneficiaries you
wish to leave a lump sum or a large specific item to.
1. Name of Beneficiary
Address: Street
City
State
Zip
Phone
Relationship/Charity
% of Estate to Distribute
%
Is Beneficiary a Minor?
Yes
No
Do you want to pass this distribution on to their children in the
event this beneficiary dies before you?
No (per stirpes)
Yes (per capita)
Per Stirpes = If the beneficiary
is to receive a distribution per stirpes, the beneficiary's children
will receive the beneficiary's distribution even if the beneficiary
is no longer alive at the time of your death.
Per Capita = If the beneficiary
is to receive a distribution per capita, he or she will receive the
distribution only if he or she is alive at the time of your death.
2. Name of Beneficiary
Address: Street
City
State
Zip
Phone
Relationship/Charity
% of Estate to Distribute
%
Is Beneficiary a Minor?
Yes
No
Do you want to pass this distribution on to their children in the
event this beneficiary dies before you?
Yes (per stirpes)
No (per capita)
3. Name of Beneficiary
Address: Street
City
State
Zip
Phone
Relationship/Charity
% of Estate to Distribute
%
Is Beneficiary a Minor?
Yes
No
Do you want to pass this distribution on to their children in the
event this beneficiary dies before you?
Yes (per stirpes)
No (per capita)
4. Name of Beneficiary
Address: Street
City
State
Zip
Phone
Relationship/Charity
% of Estate to Distribute
%
Is Beneficiary a Minor?
Yes
No
Do you want to pass this distribution on to their children in the
event this beneficiary dies before you?
Yes (per stirpes)
No (per capita)
5. Name of Beneficiary
Address: Street
City
State
Zip
Phone
Relationship/Charity
% of Estate to Distribute
%
Is Beneficiary a Minor?
Yes
No
Do you want to pass this distribution on to their children in the
event this beneficiary dies before you?
Yes (per stirpes)
No (per capita)
Per Stirpes = If the beneficiary
is to receive a distribution per stirpes, the beneficiary's children will
receive the beneficiary's distribution even if the beneficiary is no longer
alive at the time of your death.
Per Capita = If the beneficiary
is to receive a distribution per capita, he or she will receive the distribution
only if he or she is alive at the time of your death.
Contingency Beneficiary Information:
A Contingent Beneficiary is sometimes called
the "last resort beneficiary" to be the recipient of your estate
in the event that there are no other surviving beneficiaries. (Otherwise
the estate would go to the State) If you wish to provide a contingent beneficiary,
please list them below.
1. Contingent Beneficiary Name
Address: Street
City
State
Zip
Phone
Relationship/Charity
2. Contingent Beneficiary Name
Address: Street
City
State
Zip
Phone
Relationship/Charity
Special Distributions: A
Special Distribution can be made upon the death of either the Husband or
Wife, to be distributed before the final estate is divided and distributed.
Often times this is a lump sum amount or valuable property. Please list
any special distribution here. They can be listed here even though they
might be listed as a child or a beneficiary. This will not effect their
final distribution.
1. Name of Beneficiary
Relationship
Address: Street
City
State
Zip
Phone
2. Name of Beneficiary
Relationship
Address: Street
City
State
Zip
Phone
3. Name of Beneficiary
Relationship
Address: Street
City
State
Zip
Phone
4. Name of Beneficiary
Relationship
Address: Street
City
State
Zip
Phone
5. Name of Beneficiary
Relationship
Address: Street
City
State
Zip
Phone
Power of Attorney and
Wills Questions:
Please answer the following questions individually. These documents are
prepared separately for each individual, and you may have different answers
or choose to select different decision makers to make medical and financial
decisions on your behalf.
General Power of Attorney This
document will allow your Agent/Attorney-in-Fact to act on your behalf to
make major financial and property decisions. Each of you should designate
an agent below according to your wishes.
WIFE, do you want your HUSBAND as your agent?
Yes
No
If no, please list the name and address of
your Agent below:
Name of Agent
Address: Street
City
State
Zip
Phone
Please provide the names and addresses of any
Alternate Agents:
Name of Alternate Agent #1
Alternate Agent #1 Address: Street
City
State
Zip
Phone
Name of Alternate Agent #2
Alternate Agent #1 Address: Street
City
State
Zip
Phone
HUSBAND , do
you want your WIFE as your agent?
Yes
No
If no, please list the name and address of
your Agent below:
Name of Agent
Address: Street
City
State
Zip
Phone
Please provide the names and addresses of any
Alternate Agents:
Name of Alternate Agent #1
Alternate Agent #1 Address: Street
City
State
Zip
Phone
Name of Alternate Agent #2
Alternate Agent #1 Address: Street
City
State
Zip
Phone
MEDICAL DIRECTIVE/HEALTH CARE POWER OF ATTORNEY This
document will allow your designated decision
maker to act on your behalf
to make medical and health care decisions on
your behalf. Below please indicate who each of
you wish to appoint as your primary decision
maker in the event
of your death or incapacity.
WIFE, do you want
your HUSBAND as your primary decision maker?
Yes
No
If no, please list the name and address of
person you designate as your primary decision maker below:
Name
Address: Street
City
State
Zip
Phone
Please provide the
names and addresses of any alternate agents
or decision makers:
Name of 1st Alternate Agent or Decision Maker
Address: Street
City
State
Zip
Phone
Name of 2nd Alternate Agent or Decision Maker
Address: Street
City
State
Zip
Phone
Name of 3rd Alternate Agent or Decision Maker
Address: Street
City
State
Zip
Phone
Name of 4th Alternate Agent or Decision Maker
Address: Street
City
State
Zip
Phone
HUSBAND,
do you want your WIFE as your primary decision
maker?
Yes
No
If no, please list the name and address of
person you designate as your decision maker below:
Name
Address: Street
City
State
Zip
Phone
Please provide the
names and addresses of any alternate agents
or decision makers:
Name of 1st Alternate Agent or Decision Maker
1st Alternate Agent/Decision Maker Address: Street
City
State
Zip
Phone
Name of 2nd Alternate Agent or Decision Maker
Alternate Agent/Decision Maker Address: Street
City
State
Zip
Phone
Name of 3rd Alternate Agent or Decision Maker
Alternate Agent/Decision Maker Address: Street
City
State
Zip
Phone
Name of 4th Alternate Agent
Alternate Agent/Decision Maker Address: Street
City
State
Zip
Phone
LIVING WILL This
document will allow your designated decision maker to act on your behalf
to make decisions on whether to continue providing you with life support
in the event you are in a vegetative state. Below please indicate who each
of you wish to appoint as your primary decision maker in the event of your
death or incapacity.
WIFE, do you want
your HUSBAND as your primary decision maker?
Yes
No
If no, please list the name and address of
person you designate as your decision maker below:
Name
Address: Street
City
State
Zip
Phone
Please provide the
names and addresses of any alternate agents
or decision makers:
Name of 1st Alternate Agent or Decision Maker
1st Alternate Agent/Decision Maker Address: Street
City
State
Zip
Phone
Name of 2nd Alternate Agent or Decision Maker
2nd Alternate Agent/Decision Maker Address:
Street
City
State
Zip
Phone
Name of 3rd Alternate Agent or Decision Maker
3rd Alternate Agent/Decision Maker Address: Street
City
State
Zip
Phone
Name of 4th Alternate Agent or Decision Maker
4th Alternate Agent/Decision Maker Address: Street
City
State
Zip
Phone
HUSBAND,
do you want your WIFE as your primary decision
maker?
Yes
No
If no, please list the name and address of
person you designate as your decision maker below:
Name
Address: Street
City
State
Zip
Phone
Please provide the
names and addresses of any alternate agents
or decision makers:
Name of 1st Alternate/Primary
Decision Maker
1st Alternate Agent/Decision Maker Address: Street
City
State
Zip
Phone
Name of 2nd Alternate/Primary
Decision Maker
2nd Alternate Agent/Decision Maker Address: Street
City
State
Zip
Phone
Name of 3rd Alternate Primary Decision Maker
3rd Alternate Agent/Decision Maker Address: Street
City
State
Zip
Phone
Name of 4th Alternate/Primary
Decision Maker
4th Alternate Agent/Decision Maker Address: Street
City
State
Zip
Phone
POUR OVER WILL This
document is like a Last Will and Testament. The Trust has already taken
care of your assets. Here you can designate what shall happen to your body
and any other special requests.
In the event of my death, I wish for my body
to be: WIFE:
Buried
Cremated
; HUSBAND:
Buried
Cremated
Please check off the options that apply:
WIFE:
I have provided a list of instructions for my burial and funeral instructions
I have provided a Statement of Wishes for my loved ones to follow
HUSBAND
I have provided a list of instructions for my burial and funeral instructions
I have provided a Statement of Wishes for my loved ones to follow
IMPORTANT: Before clicking submit,
we recommend you print a copy of this for your records. We recommend you
use landscape mode when printing.