Questionnaire - Single With Children

Thank you for your interest! 

If you are single and have children, please complete this Questionnaire.  You may use approximations where necessary.  This information is not shared.  Once completed, I will contact you within 24-48 hours to schedule a consultation (virtual or telephone conference). 

 

I set aside :30 for this meeting to learn about you, go over this information, and provide you with recommendations and the fee for a comprehensive estate plan.  There is no cost to you for this consultation. 

 

(Personal Information)
Fill in each circle for the documents that you currently have. You may be asked to provide a copies.
Us Citizen
Veteran
Employed
Retired
Martial Status
Do you have any ongoing health issues?
Do you currently have a partner that you wish to include in your Estate Plan?
Do you have an ownership interest in a business?
If yes, what type of business?
Do you have any family members (in your bloodline) that you want to exclude from your estate plan (so they do not inherit any of your assets)?
Do you provide ongoing care or financial support for anyone (other than your minor child(ren)?
(Your Children)
Do you provide regular care or financial support for any of your adult (18 or older) Children?
Do any of your Children have special needs or receive governmental assistance or benefits?

CHILD 1

CHILD 2

CHILD 3

CHILD 4

(Your Grandchildren)
I do not have Grandchildren
Do you provide regular care or financial support for any of your Grandchild
Do any of your Grandchildren have special needs?

GRANDCHILD 1

GRANDCHILD 2

GRANDCHILD 3

GRANDCHILD 4

(Pets)
If you have pets, do you want to include a provision for their care in your estate plan?
(Assets)
REAL ESTATE (identify any real property that you have an individual or joint ownership in)
BANK ACCOUNTS (Checking, Savings, Money Market, CDs)
I do not have Grandchildren
RETIREMENT ACCOUNTS (IRA - Traditional or Roth; 401k; 403b; SEP)
LIFE INSURANCE
TANGIBLE PERSONAL PROPERTY
Vehicles (Owned)
Household Items
Boats
Jewelry, Antiques, Collections
(Additional Information)
Do you have any legal issues that I should be aware of (party to a lawsuit, divorce pending, etc.)?
Are there any family issues that you feel could impact your estate plan?
How did you hear about The Law Office of Kelly T. Braun, PLLC?
Do you currently work with a Financial Advisor?
If not, would you like a recommendation?
Do you currently work with a CPA?
If not, would you like a recommendation?
Do you currently work with (another) attorney?
By completing this Questionnaire I agree to provide accurate and complete information that I understand will be relied upon by The Law Office of Kelly T. Braun, PLLC (the Firm) in making recommendations to me. I further understand that if the information is incomplete or inaccurate, recommendations I receive may not be appropriate or the best recommendations for my situation.  

Good for you! You got one of the hardest parts of the planning done.

Thank you for taking the time to complete this form. 

You are one step closer to completing or updating your estate plan.

Thank you for completing the questionnaie, I will contact you within 24-48 hours to schedule a consultation.

For Asset OWNER list (a) self, or (b) self and other