ESTATE PLANNING WORKSHEET
Married Couples

Information provided is held in complete confidence, and is used for the sole purpose of analyzing estate planning needs and designing estate planning documents.  Preparation of this worksheet is not mandatory prior to the initial appointment with us, but if we are able to review the completed worksheet prior to your appointment, more information and value will be received during the 30-minute complimentary initial consultation.

WE OFFER A FREE
NO-OBLIGATION, 30-MINUTE CONSULTATION

During the initial appointment, we will determine your specific estate planning needs and goals.  The potential cost of probate and tax which would occur with your current plan will be analyzed, and methods of reducing costs and accomplishing goals will be discussed.  An exact quote on fees for estate planning will be provided before you decide to authorize completion of your estate plan.

	

Barone Law Office, PLC
Joseph Barone, J.D., LL.M.
607 S Main Street
Plymouth, MI  48170
(734) 414-0358 (Phone) (734) 414-0359 (Fax)
joe@baronelaw.net
www.baronelaw.net

Estate Planning Worksheet

The information requested on this worksheet may seem like none of our business, but it is very important that an estate planner understands your present situation and your wishes for the future.  This information enables us to plan the estate to accomplish future goals and to save on taxes and administrative expenses.

If all information on this worksheet is identical for you and your spouse complete only one worksheet.  If information for each spouse differs, make a copy of this worksheet so each of you has a separate one. 

			
		Date	
Husband				
	First Name		MI		Last Name	
				
	AKA
		Social Security Number		Date of Birth	
Wife				
	First Name		MI		Last Name	
				
	AKA
		Social Security Number		Date of Birth	
			
Address			
			
City
		State		Zip		County	
Phone Number		Other  Phone		Email	

Marital Status:		  Married		  Separated		Date of Marriage: ____________	  
	
If single, (including divorced or widowed and not remarried) use the Estate Planning Worksheet for single individuals.

What is your primary motivation for considering estate planning? (Select one or more)

  Probate avoidance					  Business or farm planning			
  Guardianship for minor children			  Federal estate tax planning
  Other: __________________________________________________________

How soon would you like to complete planning?  Is there a specific deadline, such as an upcoming trip, surgery, etc.?__________________________________________________________________

	
   							  	     	    Husband		Wife
   
Do you presently have a will?						 Yes	 No	         Yes   No 

Do you presently have a trust?					 Yes	 No	         Yes   No 

Are you interested in avoiding probate of your estate?		 Yes	 No	         Yes   No 

Were there any previous marriages?					 Yes	 No	         Yes   No
If yes, year marriage ended in: ______________________________

Are any of your children not from your current relationship?	 Yes	 No	         Yes   No

Do any of your children or other beneficiaries have disabilities?	 Yes	 No	         Yes   No

Do you own a farm or business?					 Yes	 No	         Yes   No

If yes, do any of your children work in the business with you?	 Yes	 No	         Yes   No

If yes, does the child working in the business have an		 Yes	 No	         Yes   No ownership interest in the business?

Are you a U.S. citizen?						 Yes	 No	         Yes   No

Have you entered into any agreements with your spouse 		 Yes	 No	         Yes   No
(such as a prenuptial or community property agreement)?
	
Do you or any family member or potential beneficiaries have 	 Yes	 No	         Yes   No
any serious health problems?

If yes, please describe briefly: ___________________________________________________________________ _________________________________________________________________________________________________

Do you own a long-term care (nursing home) insurance policy?	 Yes	 No	         Yes   No

Do you hold everything jointly with your spouse, or	 is 	           	 All joint (except   	 Some some property separate?						IRA’s, pensions, etc.)	    separate											

Net Worth: If you added the value of all property owned by yourself and your spouse including real estate, personal property, bank accounts, stocks, bonds, IRAs, and anything else you own except death benefits on life insurance, what is the approximate total value of the estate of yourself and your spouse?___________________________________

Insuring		Insuring 
What is the value of death benefits on life insurance?	Husband ______	Wife ______

What is the total amount of your outstanding liabilities? ____________________

Children or Other Beneficiaries
Name	Address	Date of Birth	Relationship	

				

Gift Tax Returns
Have gift tax returns ever been filed to report gifts made?__________***If YES, please bring copies of the returns to your appointment.
Appointments
1.	Personal Representative. The will should name a personal representative to probate the estate. (Personal representative is also sometimes referred to as executor or administrator.)  (e.g., spouse as primary personal representative, with a child, relative, friend, or corporate trustee as alternate. In situations where there are children by a previous relationship, spouse as primary personal representative may not be appropriate.)
	Husband
Personal  Representative: ____________________________________________________________
Alternate: ________________________________________________________________________
Second  Alternate: _________________________________________________________________
Wife
Personal  Representative: ____________________________________________________________
Alternate: ________________________________________________________________________
Second  Alternate: _________________________________________________________________

2.	Successor Trustee.  If you choose to avoid probate of your estate by executing a living trust during lifetime, a successor trustee should be named.  The successor trustee would be responsible for managing assets if you were unable, or in the case of a joint trust, if neither you nor your spouse were able to manage assets due to incompetence.  The successor trustee would distribute assets to beneficiaries after death, or in a joint trust, when neither you nor your spouse survives.
	Husband
Successor Trustee: _________________________________________________________________ Alternate: ________________________________________________________________________ Second Alternate: __________________________________________________________________

Wife
Successor Trustee: _________________________________________________________________ Alternate: ________________________________________________________________________ Second Alternate: __________________________________________________________________
3.	Health Care Agent. Who should be named to make medical decisions on your behalf including decisions regarding medical consents, life support issues, and nursing home admission if you were unable to make these decisions yourself? It is not necessary to appoint the same person who is your successor trustee or personal representative as your health care agent.
	Husband
Health Care Agent: ________________________________________________________________ Alternate: ________________________________________________________________________ Second Alternate: __________________________________________________________________
	Wife
Health Care Agent: ________________________________________________________________ Alternate: ________________________________________________________________________ Second Alternate: __________________________________________________________________

Plan of Distribution
1.	Specific Gifts.  Do you want to make charitable gifts, such as to a house of worship or other institution?  Do you wish to make a special gift to a particular person, such as a piece of jewelry to a particular child?
____________________________________________________________________________________________________________________________________________________________
2.	Briefly describe the plan of distribution for assets remaining after any specific gifts described above are made. (Don’t worry about tax planning or other considerations in answering this question.  We’ll consider those details later if needed.)
	All to spouse; then among children, and if a child didn’t survive, the deceased child’s share to the deceased child’s children.
  All to spouse, then equally among surviving children.
  All to spouse, then ________________________________________________________________ 
  As follows: ______________________________________________________________________
	_________________________________________________________________________________

3.	Ultimate Distribution.  You might want to provide for the distribution of your property if neither you, your spouse, nor your children/other beneficiaries named above survive.
____________________________________________________________________________________________________________________________________________________________
Please complete this section only if you have minor beneficiaries or beneficiaries with disabilities.

1.	Guardian.  If you have child(ren) or other beneficiary(ies) who are minors or who have special needs, you may need to appoint a guardian.  The guardian is responsible for the day-to-day care of the child.  It is a good idea to name an alternate guardian to act if your first choice cannot serve.
	Guardian: _____________________________________________________________________ Alternate: _____________________________________________________________________
2.	Testamentary Trustee.  You may need a trustee to manage assets for beneficiaries until they reach an age when you believe they should be capable of managing assets on their own.  A trustee can keep the beneficiary’s money invested wisely and use it for their education, support, etc., until they reach the age specified for outright distribution of assets to them.  The trustee can be a relative, friend, trust company, or other person or institution you trust to manage and distribute assets according to your wishes.  The testamentary trustee can be the same person named as the guardian, or could be a different person or institution.
Testamentary Trustee: ___________________________________________________________ Alternate: _____________________________________________________________________
3.	Age of Distribution. If you do establish a trust to allow a third party to manage assets for beneficiaries, then it is necessary for you to decide when the beneficiaries will be mature enough to manage assets on their own.  You may want to give each beneficiary his or her share at the time the beneficiary reaches a particular age. You may consider splitting the distribution, such as ½ at age 25 and the balance at age 30, or 1/3 at 21, 1/3 at 25, and 1/3 at 35.  You may use any age or combination of ages that you choose. 
____________________________________________________________________________________________________________________________________________________________

General Questions
Notes and Questions: Please note anything else which may be of importance in planning your estate, or note any questions you may have.

Income/Asset/Liability Information
Please list your income/asset/liability information in the appropriate category below.
Attach a separate page if necessary.
				     
Income		Husband		Community/
Joint		Wife	
Earned Monthly Income from Labor							
Monthly Social Security Income							
Monthly Pension Income							
Other Monthly Income							

Type of Asset	
Title in Which Held
(Husband sole, Wife sole, Joint with spouse, Joint with third party, Tenants in common, etc.)	Current Value	
Real Estate (Include type of property e.g., residential, agricultural, commercial, or manufacturing.)	
Personal Residence			
Vacant Land			
Other:			
Liquid Assets (Include account number and address where held.)		
Cash on Hand			
Government and Publicly Traded Securities			
Unlisted Securities (Not Publicly Traded)			
Money Market Accounts			
Equity in Business
 Sole Prop.  Partnership			
Notes and Loans Receivable			
Checking Accounts			
Savings Accounts			
Certificates of Deposit			
Automobiles			
Other Personal Property			
Annuities	Owner	Beneficiary	Current Value	
IRAs				
Pension/Profit Sharing				
Life Insurance			Cash Value	Death Benefit

Other Assets				
Liabilities	Name Loan Taken In
(Husband, Wife etc.)	Amount Owed