APPENDIX A
Fact Sheet for Last Will and Testament
Date: ___________________
SECTION 1: PERSONAL INFORMATION
About your spouse:
SECTION 2: GENERAL INFORMATION
Circle yes or no for each question.
| Yes | No | Do you have a will or trust now? |
| Yes | No | Are you expecting to receive property or money from:Inheritance_____Gift_____Judgment_____Other |
| Yes | No | Do you have any living children? If so, how many?_____ |
| Yes | No | Do you have any deceased children? If so, how many?_____ |
| Yes | No | Are all your children legally yours?(e.g., adopted, stepchild) |
| Yes | No | Do you have any children under 18? If so, how many?_____ |
| Yes | No | Do you have any children who require special care? |
| Yes | No | Do you have any grandchildren? If so, how many?_____ |
| Yes | No | Do you have any brothers or sisters still living?If so, how many?_____ |
| Yes | No | Does your spouse have any brothers or sisters still living? If so, how many?_____ |
| Yes | No | Do you have any children from a relationship other than with your current spouse? |
| Yes | No | Do you want to specifically disinherit anyone? If so, who?_____ |
| Yes | No | Do you have long-term health care coverage? |
SECTION 3: CURRENT ESTATE VALUE
Circle yes or no for each question.
SECTION 4: APPOINTMENTS
The following ...
