Law Offices of Robert Craig Wallach PA
12486 West Atlantic Avenue
Coral Springs, FL 33071
(954) 461-0015
Estate Planning Worksheet
Two Parties

Thank you so much for contacting our law office! Please read the privacy policy below, and then fill out this form in its entirety prior to our consultation.

This intake form collects information for two contacts who intend to create an Estate Plan together such as a married couple or life partners.  It asks for personal information for two different people referred to ask Client 1 and Client 2 below.  If either party is unable to answer questions on behalf of the other person, the form progress can be saved for the second party to complete at a later time.  If you are a single individual and creating an estate plan for yourself only, please contact our office for the intake form targeted for single individuals.

Privacy Policy
All information received from a client is strictly confidential. Our firm takes every step possible to protect your privacy. The data submitted via this form is encrypted and secured using industry-standard 256-bit SSL encryption.

Your Social Security number and other personal information will only be used in the event that you hire the firm to represent you in your legal matter, and then only when necessary in limited use during the course of your case.

Social Security numbers are most often used to positively identify parties. Most courts require Social Security numbers of all parties in a case. Some other examples of how this information may be used include:

  • initial service
  • in court orders
  • in required reports or other documents filed with the State

If you have any questions, please don't hesitate to contact our law office. We look forward to working with you!

Contact information: Client 1

Emails
*
Upon submission, a copy of this form will be sent to the primary email.
Addresses
Phone numbers

(other names used to title property and accounts)

if applicable

if applicable

if applicable

Contact information: Client 2

Emails
*
Addresses
Phone numbers

(other names used to title property and accounts)

if applicable

if applicable

if applicable

If applicable, please fill out the following information.

ex: Client 1's Child, Client 2's Child, Sibling, Cousin, etc.

Special Needs, Concerns, Adopted, etc.

If applicable, please fill out the following information.

ex: Client 1's Child, Client 2's Child, Sibling, Cousin, etc.

Special Needs, Concerns, Adopted, etc.

If applicable, please fill out the following information.

ex: Client 1's Child, Client 2's Child, Sibling, Cousin, etc.

Special Needs, Concerns, Adopted, etc.

If applicable, please fill out the following information.

ex: Client 1's Child, Client 2's Child, Sibling, Cousin, etc.

Special Needs, Concerns, Adopted, etc.

If applicable, please fill out the following information.

ex: Client 1's Child, Client 2's Child, Sibling, Cousin, etc.

Special Needs, Concerns, Adopted, etc.

If applicable, please fill out the following information.

ex: Client 1's Child, Client 2's Child, Sibling, Cousin, etc.

Special Needs, Concerns, Adopted, etc.

If applicable, please fill out the following information.

ex: Client 1's Child, Client 2's Child, Sibling, Cousin, etc.

Special Needs, Concerns, Adopted, etc.

Please rate the following as to how important they are to you:

(Please list below)

(Please check “Yes” or “No” for your answer)

Arizona, California, Idaho, Louisiana, Nevada, New Mexico, Texas, Washington, or Wisconsin

Instructions for completing the Property Information checklist:

General Headings
This Property Information checklist helps you list all the property you own and what it is worth. If you do not own property under a particular heading, just leave that section blank.

Type
Immediately after the heading for each kind of property is a brief explanation of what property you should list under that heading.

“Owner” of Property
How you own your property is extremely important for purposes of properly designing and implementing your estate plan. For each property, please indicate how the property is titled. When doing so, please use the following abbreviations:

C1
Client 1's Name alone, with no other person.

C2
Client 2's Name Alone, with no other person.

JTS
If married, Joint Tenancy with spouse

JTO 
Joint Tenancy with someone other than a spouse, i.e., a child, parent, etc.

?
If you cannot determine how the property is owned

TYPE: Any interest in real estate including your family residence, vacation home, timeshare, vacant land, etc.

if applicable, please select "Fill Out Real Property Information" and add the appropriate information

if applicable, please select "Fill Out Real Property Information" and add the appropriate information

if applicable, please select "Fill Out Real Property Information" and add the appropriate information

if applicable, please select "Fill Out Real Property Information" and add the appropriate information

if applicable, please select "Fill Out Real Property Information" and add the appropriate information

* Joint Property values enter 1/2 in Client 1's space and 1/2 in Client 2's space.

TYPE: List separately only major personal effects such as jewelry, collections, antiques, furs, and all other valuable non-business personal property (indicate type below and give a lump sum value for miscellaneous, less valuable items.).

if applicable, please select "Fill Out Furniture or Other Personal Effects Information" and add the appropriate information

if applicable, please select "Fill Out Furniture or Other Personal Effects Information" and add the appropriate information

if applicable, please select "Fill Out Furniture or Other Personal Effects Information" and add the appropriate information

if applicable, please select "Fill Out Furniture or Other Personal Effects Information" and add the appropriate information

* Joint Property values enter 1/2 in Client 1's space and 1/2 in Client 2's space.

TYPE: For each motor vehicle, boat, RV, etc. please list the following: description, how titled, market value and encumbrance:

if applicable, please select "Fill Out Vehicle Information" and add the appropriate information

if applicable, please select "Fill Out Vehicle Information" and add the appropriate information

if applicable, please select "Fill Out Vehicle Information" and add the appropriate information

if applicable, please select "Fill Out Vehicle Information" and add the appropriate information

if applicable, please select "Fill Out Vehicle Information" and add the appropriate information

* Joint Property values enter 1/2 in Client 1's space and 1/2 in Client 2's space.

TYPE: Checking Account “CA”, Savings Account “SA”, Certificates of Deposit “CD”, Money Market “MM” (indicate type below). Do not include IRAs or 401(k)s here

if applicable, please select "Fill Out Bank Account Information" and add the appropriate information

if applicable, please select "Fill Out Bank Account Information" and add the appropriate information

if applicable, please select "Fill Out Bank Account Information" and add the appropriate information

if applicable, please select "Fill Out Bank Account Information" and add the appropriate information

if applicable, please select "Fill Out Bank Account Information" and add the appropriate information

* Joint Property values enter 1/2 in Client 1's space and 1/2 in Client 2's space.

TYPE: List any and all stocks and bonds you own. If held in a brokerage account, lump them together under each account. (indicate type below)

if applicable, please select "Fill Out Stock and/or Bond Information" and add the appropriate information

if applicable, please select "Fill Out Stock and/or Bond Information" and add the appropriate information

if applicable, please select "Fill Out Stock and/or Bond Information" and add the appropriate information

if applicable, please select "Fill Out Stock and/or Bond Information" and add the appropriate information

if applicable, please select "Fill Out Stock and/or Bond Information" and add the appropriate information

* Joint Property values enter 1/2 in Client 1's space and 1/2 in Client 2's space.

TYPE: Term, whole life, split dollar, group life, annuity. 

ADDITIONAL INFORMATION: Insurance company, type, face amount (death benefit), whose life is insured, who owns the policy, the current beneficiaries, who pays the premium, and who is the life insurance agent.

TYPE: Pension (P), Profit Sharing (PS), H.R. 10, IRA, SEP, 401(K). 

ADDITIONAL INFORMATION: Describe the type of plan, the plan name, the current value of the plan, and any other pertinent information.

TYPE: General and Limited Partnerships, Sole Proprietorships, privately-owned corporations, professional corporations, oil interests, farm, and ranch interests.

ADDITIONAL INFORMATION: Give a description of the interests, who has the interest, your ownership in the interests, and the estimated value of the interests.

TYPE: Mortgages or promissory notes payable to you, or other moneys owed to you.

if applicable, please select "Fill Out Money Owed to You Information" and add the appropriate information

if applicable, please select "Fill Out Money Owed to You Information" and add the appropriate information

if applicable, please select "Fill Out Money Owed to You Information" and add the appropriate information

if applicable, please select "Fill Out Money Owed to You Information" and add the appropriate information

* Joint Property values enter 1/2 in Client 1's space and 1/2 in Client 2's space.

TYPE: Gifts or inheritances that you expect to receive at some time in the future; or moneys that you anticipate receiving through a judgment in a lawsuit. Describe in appropriate detail.

TYPE: Other property is any property that you have that does not fit into any listed category.

if applicable, please select "Fill Out Other Asset Information" and add the appropriate information

if applicable, please select "Fill Out Other Asset Information" and add the appropriate information

if applicable, please select "Fill Out Other Asset Information" and add the appropriate information

if applicable, please select "Fill Out Other Asset Information" and add the appropriate information

* Joint Property values enter 1/2 in Client 1's space and 1/2 in Client 2's space.

PERSONS TO ACT FOR YOU:

If you have any children under the age of 18, list in order of preference who you wish to be guardian.

if applicable, please select "Designate a Guardian for Minor Children" and add the appropriate information

if applicable, please select "Designate a Guardian for Minor Children" and add the appropriate information

Usually the Maker will be the Trustee of his or her own trust. Often, both clients, jointly. Allows you to continue to jointly control your assets as before.

if applicable, please select "Designate an Initial Trustee" and add the appropriate information

if applicable, please select "Designate an Initial Trustee" and add the appropriate information

If you were unable to make decisions for yourself, who would you want to make decisions for you with regard to your property and assets?

if applicable, please select "Designate an Initial Trustee" and add the appropriate information

if applicable, please select "Designate an Initial Trustee" and add the appropriate information

if applicable, please select "Designate a Disability Trustee" and add the appropriate information

If you were unable to make decisions for yourself, who would you want to make decisions for you with regard to your property and assets?

if applicable, please select "Designate a Disability Trustee" and add the appropriate information

if applicable, please select "Designate a Disability Trustee" and add the appropriate information

if applicable, please select "Designate a Disability Trustee" and add the appropriate information

After your death, who do you want carrying out your instructions, for distribution to and, if desired, management of property for your beneficiaries?

if applicable, please select "Designate a Death Trustee" and add the appropriate information

if applicable, please select "Designate a Death Trustee" and add the appropriate information

if applicable, please select "Designate a Death Trustee" and add the appropriate information

After your death, who do you want carrying out your instructions, for distribution to and, if desired, management of property for your beneficiaries?

if applicable, please select "Designate a Death Trustee" and add the appropriate information

if applicable, please select "Designate a Death Trustee" and add the appropriate information

if applicable, please select "Designate a Death Trustee" and add the appropriate information

If you were unable to make financial decisions for yourself, who would you want to make those decisions for you?

if applicable, please select "Designate an Agent" and add the appropriate information

if applicable, please select "Designate an Agent" and add the appropriate information

if applicable, please select "Designate an Agent" and add the appropriate information

If you were unable to make financial decisions for yourself, who would you want to make those decisions for you?

if applicable, please select "Designate an Agent" and add the appropriate information

if applicable, please select "Designate an Agent" and add the appropriate information

if applicable, please select "Designate an Agent" and add the appropriate information

If you were unable to make decisions for yourself, who would you want to make decisions for you with regard to your medical treatment?

if applicable, please select "Designate an Agent" and add the appropriate information

if applicable, please select "Designate an Agent" and add the appropriate information

if applicable, please select "Designate an Agent" and add the appropriate information

If you were unable to make decisions for yourself, who would you want to make decisions for you with regard to your medical treatment?

if applicable, please select "Designate an Agent" and add the appropriate information

if applicable, please select "Designate an Agent" and add the appropriate information

if applicable, please select "Designate an Agent" and add the appropriate information

List any specific gifts of real estate or cash gifts you wish to make to either individuals or charities. Indicate whether these gifts are to be made even if the other client is alive.

if applicable, please select "Bequest a Gift" and add the appropriate information

if applicable, please select "Bequest a Gift" and add the appropriate information

if applicable, please select "Bequest a Gift" and add the appropriate information

if applicable, please select "Bequest a Gift" and add the appropriate information

if applicable, please select "Bequest a Gift" and add the appropriate information

•  TO SURVIVING CLIENT WITHOUT TAX PLANNING: We recognize this does not provide any tax planning which may result in our beneficiaries paying significant optional estate taxes.

    •  All to surviving client. 
    •  _________% to surviving client.
    •  Minimum allowed by law to surviving client.

•  DIVIDE INTO MARITAL AND FAMILY TRUSTS: Designed to maximize estate tax savings. To accomplish this, an amount up to the applicable exclusion amount will be transferred to the Family Trust and the balance, if any, to the Marital Trust. This is sometimes referred to as “A/B Trust Planning”. The Marital Trust is sometimes referred to as the “A Trust” or “QTIP Trust”. The Family Trust is sometimes referred to as the “B Trust”, “By-Pass Trust” or “Credit Shelter Trust”. Also provides protection for surviving client from creditors and predators. You decide how much control you want the surviving client to have. In the event of remarriage protects property for your heirs from a new client in case of death or divorce.

•  OUTRIGHT: We want to leave property outright to the surviving client. We recognize that this offers no
protection from creditors or predators. Allows surviving client to leave property to whomever surviving client wants.
Also allows a new spouse/partner to possibly make claim on property in case of death or divorce

•  GENERAL APPOINTMENT TRUST: All income and principal are available to the surviving client upon
demand. The surviving client is free to do as he or she pleases. This would include the ability to remove all property in
the Marital Share from the trust.

•  ALL INCOME – PRINCIPAL FOR NEEDS: All income is distributed to surviving client; principal is available
for his or her needs (health, education, maintenance, and support).

•  ONLY INCOME: Only income is distributed to surviving client. Principal is not available to the surviving client.

•  ALL INCOME – PRINCIPAL FOR NEEDS: All income is distributed to surviving client; principal is available for needs (health, education, maintenance, and support).

    Are descendants permissible beneficiaries of principal?____

•  INCOME AND PRINCIPAL FOR NEEDS: All income and principal is available for needs. Income may be accumulated and not distributed.

    Are descendants permissible beneficiaries of income and/or principal?____

•  ONLY INCOME: Only income is distributed to surviving client. Principal is not available to the surviving client.

If so, to whom may the surviving client distribute your property:

•  DISTRIBUTE OUTRIGHT TO OUR BENEFICIARIES: Provides no protection from creditors, predators, or from themselves.

•  STRUCTURED TRUST: You determine how long the property is to remain in trust. During the period of time the property is held in trust it is available to the beneficiary for needs (health, education, maintenance, and support). You may give written instructions to the trustee outlining guidelines to follow in determining the beneficiary’s needs. You may provide for a staggered distribution of principal. For example:. 1/3 at age 30 and balance at age 40. You decide who will manage the property and to carry out your distribution instructions. Does the beneficiary have a right to be a co-trustee and/or choose his or her own co-trustee? You decide how the trust is designed. List your desires:

Who do you want to receive your property in the remote event that no one listed above is alive to receive your property? Determining the remote contingent beneficiary is not so important that it should cause you to delay completion of your entire estate plan. It can always be changed at a later date.

In the remote event no one listed above is alive to receive my property I want my property distributed as follows:

    •   To each Client’s heirs-at-law.
    •  One-half to Client 1's heirs-at-law and one-half to Client 2's
 heirs at law.
    •  To the following named individuals and/or charities:

In some instances, it is necessary for us to review other documents before we can make planning recommendations. If applicable, please bring the documents requested below with you to our first meeting:

1. Copies of all deeds to real estate owned by you.
2. Copies of the most recent financial statements evidencing your ownership of bank accounts, investment accounts, retirement accounts, and annuities.
3. Copies of any stock or bond certificates.
4. Do you have any Long-Term Care Policies? If yes, please bring a copy
5. Is there a Divorce Decree or Property Settlement Agreement for divorce under which continued obligations exist (child or spousal support, maintain life insurance policy, etc.)? If yes, please bring a copy
6. Last 3 years of personal income, corporate, or partnership tax returns.
7. Have you ever filed a gift tax, estate tax, or trust tax returns? If yes, please bring a copy.
8. Copies of any existing planning documents, including wills, trusts, powers of attorney, health care directives, etc.

When you are finished, please click the "Submit" button.