TEST – DO NOT USE ESP Questionnaire

CONFIDENTIAL ESTATE PLANNING QUESTIONNAIRE

The following questionnaire is designed to expedite our efforts to plan your estate. Whether you are a new or an established client, we have found this questionnaire extremely helpful, and therefore ask you to complete it prior to your appointment. Those questions that do not apply to your family or financial situation may simply be left blank. Please feel free to attach additional pages where space is needed or to provide other information you feel is relevant. There is a space below to upload any of your documents securely. Our site uses SSL Encryption to protect your data.

NOTE: IF YOU NEED TO COME BACK TO COMPLETE THE QUESTIONNAIRE, YOU CAN HIT “SAVE AND CONTINUE” AT THE BOTTOM OF THIS PAGE. YOU WILL RECEIVE AN EMAIL WITH A LINK TO CONTINUE/COMPLETE THE QUESTIONNAIRE. DO NOT RELOAD OR REFRESH THIS PAGE AS YOU COMPLETE THE FORM, OR ELSE YOUR INFORMATION MAY BE DELETED.
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Name(Required)
Address(Required)
MM slash DD slash YYYY
Spouse / Partner Name
MM slash DD slash YYYY

Beneficiaries

Beneficiaries can be a spouse/partner, child, grandchild or non-relative. Please use the + button to the right to add additional beneficiaries.
Beneficiaries
Name
Relation
Addresss
 
Please use the + button to the right to add additional beneficiaries.

Business Interests

Please provide detail regarding any business interests you hold
Are you interested in Succession Planning

Professional Advisors

Please provide contact information for attorneys, financial advisors, brokers, insurance agents, etc.
Advisor
Name
Title
Email Address
Phone Number
 
Please use the + button to the right to add additional advisors.

Assets

Please provide information regarding any personal assets. If you have statements, deeds, property tax bills, etc., please attach them below, or bring them to your appointment.
Please List Any Monthly Family Income (ie: Wages, Social Security, Retirement, Other)
Income Source
Amount
 
Please use the + button to the right to add additional income.
Bank Accounts
Name of Financial Institution
Account Value
Purpose of Account
 
Please use the + button to the right to add additional accounts.
Do You Own Real Property?
Please List Any Valuable Personal Property (ie: Vehicles, Jewelery, Home Furnishings, Artwork)
Please use the + button to the right to add additional personal property.

Personal Representatives

These are people you trust to represent you and carry out your wishes, financial and otherwise.
Who Do You Trust to Make Financial Decisions?
Name
Address
 
Please use the + button to the right to add additional people.
Who Do You Trust to Make Healthcare Decisions?
Name
Address
 
Please use the + button to the right to add additional people.
Who Do You Trust to Take Care of Your Children?
Name
Address
 
Please use the + button to the right to add additional people.
Who Do You Trust to Take Care of Your Pets?
Name
Address
 
Please use the + button to the right to add additional people.

Specific Bequests

Are there any specific requests you want to discuss in your appointment (ie: charitable gifts, items or money to go to specific people?)

Thank You

Thank you for taking the time to complete this questionnaire; it is very helpful for your appointment. If you have any questions regarding this questionnaire or your appointment, please contact James Gonda at 518-459-2100.
Please provide any relevant documents you would like to share with our attorneys.
Drop files here or
Max. file size: 20 MB.

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