Information for Trust/Will Preparation - Law Firm The Barbknecht Firm P.C. Attorneys Dallas, Texas

Saturday, July 31, 2010

Appointment:

Date:
Time:	AM/PM
To see:

INFORMATION FOR TRUST/WILL PREPARATION

Your Information:

Name:	Social Security Number:
Address:	Date of Birth:
City/State/Zip	County:
Phone:	Email Address:

Your Spouse’s Information:

Name:	Social Security Number:
Address:	Date of Birth:
City/State/Zip	County:
Phone:

List names of all prior spouses, dates of divorce or other occurrence, which caused the marriage to terminate:

1.		How marriage terminated:
2.		How marriage terminated:
3.		How marriage terminated:
4.		How marriage terminated:

List names, address, and dates of birth of all children (including adopted):

1.	Address:	DOB:
2.	Address:	DOB:
3.	Address:	DOB:
4.	Address:	DOB:
5.	Address:	DOB:
6.	Address:	DOB:

Please describe all real property owned by you, in whole or in part (Example: House and Lot located at: ):

Please list the name address, relationship, and telephone number for the person(s) you wish to be appointed executor(rix)of your estate. Please list two (2) additional persons to serve as alternate executor(rix):

1.	Executor:	Phone Number:
	Address:	City/State/Zip:
2.	1st Alternate Executor:	Phone Number:
	Address:	City/State/Zip:
3.	2nd Alternate Executor:	Phone Number:
	Address:	City/State/Zip:

If you wish to establish a trust within your will, please list the name, address, relationship, and telephone number of the person(s) you wish to be appointed trustee of your trust, if any. Please list two (2) additional persons to serve as Successor Trustee:

1.	Trustee:	Phone Number:
	Address:	City/State/Zip:
2.	1st Successor Trustee:	Phone Number:
	Address:	City/State/Zip:
3.	2nd Successor Trustee:	Phone Number:
	Address:	City/State/Zip:

Please list the name and address of the person(s) and the interest or specific item each person is to receive in your will. (Example: Diamond ring, family heirloom, antique furniture):

1.	Name:	Phone Number:
	Address:	City/State/Zip:
	Item of Interest:	Percentage(%)
2.	Name:	Phone Number:
	Address:	City/State/Zip:
	Item of Interest:	Percentage(%)
3.	Name:	Phone Number:
	Address:	City/State/Zip:
	Item of Interest:	Percentage(%)
4.	Name:	Phone Number:
	Address:	City/State/Zip:
	Item of Interest:	Percentage(%)

Please list the name and address of the person or persons and the interest you wish each person(s) to receive in the residuary or remainder of your estate after all debts have been paid and the specific bequests have been distributed:

1.	Name:	Phone Number:
	Address:	City/State/Zip:
	Item of Interest:	Percentage(%):
2.	Name:	Phone Number:
	Address:	City/State/Zip:
	Item of Interest:	Percentage(%):
3.	Name:	Phone Number:
	Address:	City/State/Zip:
	Item of Interest:	Percentage(%):
4.	Name:	Phone Number:
	Address:	City/State/Zip:
	Item of Interest:	Percentage(%):
5.	Name:	Phone Number:
	Address:	City/State/Zip:
	Item of Interest:	Percentage(%):

If you are the parent of a minor child, please identify the person and/or persons to be appointed Guardian of the Minor in the event of your death:

1.	Name:	Phone Number:
	Address:	City/State/Zip/County:
	SSN:	Date of Birth:
2.	Name:	Phone Number:
	Address:	City/State/Zip/County:
	SSN:	Date of Birth:

List the person(s) who will make Health Care decisions for you:

1.	Name:	Phone Number:
	Address:	City/State/Zip:
2.	Name:	Phone Number:
	Address:	City/State/Zip:
3.	Name:	Phone Number:
	Address:	City/State/Zip:

Please list the person(s) who will consult with your treating physician regarding withholding/continuation of life support:

1.	Name:	Phone Number:
	Address:	City/State/Zip:
2.	Name:	Phone Number:
	Address:	City/State/Zip:
3.	Name:	Phone Number:
	Address:	City/State/Zip:

Please list the persons to be appointed the Guardian of your Person and Estate in the event of incapacity:

1.	Name:	Phone Number:
	Address:	City/State/Zip:
2.	Name:	Phone Number:
	Address:	City/State/Zip:
3.	Name:	Phone Number:
	Address:	City/State/Zip:

Client	Client
Date	Date