Want to know more about a “trust”?  Here are some intake questions that give you an idea of what a trust is about and what “goes into it.”  Please note this information questionnaire is not an explanation of a trust but an explanation of information needed to draft a trust.  Your Elder Law attorney will consult with you about your unique situation and provision that need to be drafted to tailor it to your exact situation.

TRUST QUESTIONNAIRE

(This form can be downloaded in pdf format from our Clients page)

Client’s Name(s)____________________________________________________

Home Telephone___________________________________________________

Husband’s Work___________________________________________________

Wife’s Work______________________________________________________

Principal Residence

Street Address___________________________________________________

City__________________________State______Zip_____________________

Vacation Home

Street Address___________________________________________________

City__________________________State______Zip_____________________

I.PERSONAL DATA

A.HUSBAND AND WIFE

Husband’s full name______________________________________________

U.S. Citizen_____________ If not, what Country___________________

Marriage date____________________

Previous marriages (list names of former spouse and children; provide a copy of the Divorce Decree)__________________________________________________________________________

Wife’s full name_________________________________________________

U.S. Citizen_____________ If not, what Country___________________

Marriage date____________________

Previous marriages (list names of former spouse and children; provide a copy of the Divorce Decree) _________________________________________________________________________________

B. Children

Is there a physical possibility of more children_________________

Are any of your children adopted; if so, please list_______________________________________

Are any of your children handicapped or in poor health, if so, please list_______________________

Are any of your children deceased, if so, please list_______________________

Please list any grandchildren of such deceased children

_________________________________________________________________

1. Child’s name________________________Date of Birth_______________

    Address______________________________________________________

    Spouse’s name_________________________________________________

    Child’s children (names and ages)____________________________________________________

    _______________________________________________________________________________

2. Child’s name________________________Date of Birth_______________

    Address______________________________________________________

                Spouse’s name_________________________________________________

    Child’s children (names and ages)___________________________________________________

    ______________________________________________________________________________

3. Child’s name________________________Date of Birth_______________

    Address______________________________________________________

Spouse’s name_________________________________________________

    Child’s children (names and ages)_____________________________________________________

    ________________________________________________________________________________

4. Child’s name________________________Date of Birth_______________

    Address______________________________________________________

    Spouse’s name_________________________________________________

    Child’s children (names and ages)_____________________________________________________

    ________________________________________________________________________________

C. Pets. Do you want to provide for the care of your pets should you become disabled or pass away?

HUSBAND YES________ NO________

WIFE YES________ NO________

Caregiver choice_________________________________________

Name/Type of Pet(s)______________________________________

II. CHOICE OF TRUSTEE(The trustee is responsible for managing assets held in trust for the benefit of specified beneficiaries.)

HUSBAND

Initial Trustee__________________________________________________ Address________________________________________________________

City________________________State______Telephone_________________

Co-Trustee_____________________________________________________

Address________________________________________________________

City________________________State______Telephone_________________

Successor Trustee________________________________________________

Address_________________________________________________________

City________________________State______Telephone_________________

WIFE

Initial Trustee __________________________________________________

Address________________________________________________________

City________________________State______Telephone_________________

Co-Trustee_____________________________________________________

Address________________________________________________________

City________________________State______Telephone_________________

Successor Trustee________________________________________________

Address_________________________________________________________

City________________________State______Telephone_________________

III. TRUST ARRANGEMENTS

A. Do you want the trust funds to be held in one common fund until your youngest has the opportunity to obtain a college education?

HUSBAND YES________ NO________

WIFE YES________ NO________

B. If your children are under a specified age, should their share be held in trust until a particular age?

HUSBAND YES________ NO________ If so, what age?________________________

WIFE YES________ NO________If so, what age?________________________

C. Do you want all of a child’s share to be distributed at one time or a percentage distributed at a particular age?

HUSBAND One time distribution_________________________________

Age of distribution______________________________________________

WIFEOne time distribution____________________________________

Age of distribution______________________________________________

D. Does your child’s children take his/her parents’ share if your child does not survive you?

HUSBAND YES________ NO________

WIFE YES________ NO________

E. CHOICE OF GUARDIAN FOR MINOR CHILDREN IF BOTH GRANTORS ARE DECEASED_____________________________________________________________

F. CARE INSTRUCTIONS FOR ANY MINOR CHILDREN

_________________________________________________________________________________

_________________________________________________________________________________

_________________________________________________________________________________

_________________________________________________________________________________

V. FINANCIAL DATA(Designate whether owned by husband(H) or wife (W), or jointly owned (J).

A. REAL ESTATE OWNED

1. Legal Description_________________________________________________________________

_________________________________________________________________________________

_________________________________________________________________________________

Owner_______________________________Date Acquired________________

Cost_________________Lien_________________Value__________________

2. Legal Description_________________________________________________________________

_________________________________________________________________________________

_________________________________________________________________________________

Owner_______________________________Date Acquired________________

Cost_________________Lien_________________Value__________________

3. Legal Description_________________________________________________________________

_________________________________________________________________________________

_________________________________________________________________________________

Owner_______________________________Date Acquired________________

Cost_________________Lien_________________Value__________________

B. STOCKS AND BONDS

Company__________________________________________________________

Type____________________# of Shares__________ Value_________________

Owner____________________________________________________________

Company__________________________________________________________

Type____________________# of Shares__________ Value_________________

Owner____________________________________________________________

C. BANK ACCOUNTS

Bank____________________________________Type_____________________

Owner___________________________________Balance__________________

Bank____________________________________Type_____________________

Owner___________________________________Balance__________________

Bank____________________________________Type_____________________

Owner___________________________________Balance__________________

Bank____________________________________Type_____________________

Owner___________________________________Balance__________________

D. BUSINESS INTERESTS

Name____________________________________Type*___________________

Owner___________________________________Value____________________

*Type: C-Corporation P-Partnership S-S Corporation SP-Sole Partnership

G. PLEASE DESCRIBE ANY RETIREMENT PLAN, PROFIT SHARING PLAN, ETC. (LIST EQUITY)

__________________________________________________________________________________

__________________________________________________________________________________

__________________________________________________________________________________

__________________________________________________________________________________

H.LIFE INSURANCE OR ANNUITIES

Company_______________________________________Type_______________

Amount______________________________Cash value____________________

Beneficiary________________________________________________________

Accountant or Tax Preparer _________________________________________

Address__________________________________________________________

Phone____________________________________

Stock Broker______________________________________________________

Address__________________________________________________________

Phone____________________________________

Financial Planner__________________________________________________

Address__________________________________________________________

Phone____________________________________

I. ESTIMATED GROSS ESTATE

Husband only__________________________________

Wife only_____________________________________

Joint_________________________________________

Total_________________________________________

Please add additional sheets as necessary.