Probate Client Intake Form

If you are a responsible family member of a deceased person who died without a will or have been named as the “executor” or “personal representative” in a deceased person’s will, it is advisable that you seek the counsel of an experienced probate lawyer to help you through the probate process. In order to do the best possible job, your attorney needs information about the deceased, the deceased’s estate plan, and the deceased’s assets and liabilities. At your first meeting with your attorney, you should be prepared to provide, as applicable, the following information.

CLIENT INFORMATION

Contact information

Prefix

First name *

Middle name

Last name *

Emails

Address *

Type

Upon submission, a copy of this form will be sent to the primary email.

Add email

Addresses

Street address

Country

City

State/Region

Zip/Postal code

Address type

Add address

Phone numbers

Phone number

Type

Add phone number

Your Relationship to the Deceased:

Your Social Security Number:

Social Security Numbers are required by the court to file documents.

IDENTITY OF DECEASED

Full Legal name of the Deceased:

Deceased’s date of death:

Deceased’s date of birth:

Deceased’s Social Security Number:

Do you have the Death Certificate?

Yes

ESTATE PLAN

Did the Deceased have an existing Will?

(If there is a Will, please bring the original to your initial consultation.)

Yes

Unknown

Did the Deceased have an existing Trust?

(If yes, please bring the original, signed Trust with you to your initial consultation.)

Yes

Unknown

FAMILY INFORMATION

Was the Deceased married?

Yes

Is the Deceased’s spouse still living?

Yes

Deceased’s Children/Heirs

For each child/Heir, please select "Yes" and complete the requested information. If it's not applicable, please select "No".

Child/Heir #1:

Yes

Full Legal Name: Address: Telephone Number: Date of Birth: Which of the following best describes the child’s relationship to you?

Naturally born, Adopted, Step-child

Is the child living or deceased?

If deceased, Date and location of death

If deceased, are there any living children?

If yes, please complete the questions below

#1 Full Legal Name: #1 Address: #1 Age: #1 If Minor, Full legal name of guardian or parent: #2 Full Legal Name: #2 Address: #2 Age: #2 If Minor, Full legal name of guardian or parent:

Child/Heir #2:

Yes

Full Legal Name: Address: Telephone Number: Date of Birth: Which of the following best describes the child’s relationship to you?

Naturally born, Adopted, Step-child

Is the child living or deceased?

If deceased, Date and location of death

If deceased, are there any living children?

If yes, please complete the questions below

#1 Full Legal Name: #1 Address: #1 Age: #1 If Minor, Full legal name of guardian or parent: #2 Full Legal Name: #2 Address: #2 Age: #2 If Minor, Full legal name of guardian or parent:

Child/Heir #3:

Yes

Full Legal Name: Address: Telephone Number: Date of Birth: Which of the following best describes the child’s relationship to you?

Naturally born, Adopted, Step-child

Is the child living or deceased?

If deceased, Date and location of death

If deceased, are there any living children?

If yes, please complete the questions below

#1 Full Legal Name: #1 Address: #1 Age: #1 If Minor, Full legal name of guardian or parent: #2 Full Legal Name: #2 Address: #2 Age: #2 If Minor, Full legal name of guardian or parent:

Child/Heir #4:

Yes

Full Legal Name: Address: Telephone Number: Date of Birth: Which of the following best describes the child’s relationship to you?

Naturally born, Adopted, Step-child

Is the child living or deceased?

If deceased, Date and location of death

If deceased, are there any living children?

If yes, please complete the questions below

#1 Full Legal Name: #1 Address: #1 Age: #1 If Minor, Full legal name of guardian or parent: #2 Full Legal Name: #2 Address: #2 Age: #2 If Minor, Full legal name of guardian or parent:

Child/Heir #5:

Yes

Full Legal Name: Address: Telephone Number: Date of Birth: Which of the following best describes the child’s relationship to you?

Naturally born, Adopted, Step-child

Is the child living or deceased?

If deceased, Date and location of death

If deceased, are there any living children?

If yes, please complete the questions below

#1 Full Legal Name: #1 Address: #1 Age: #1 If Minor, Full legal name of guardian or parent: #2 Full Legal Name: #2 Address: #2 Age: #2 If Minor, Full legal name of guardian or parent:

Child/Heir #6:

Yes

Full Legal Name: Address: Telephone Number: Date of Birth: Which of the following best describes the child’s relationship to you?

Naturally born, Adopted, Step-child

Is the child living or deceased?

If deceased, Date and location of death

If deceased, are there any living children?

If yes, please complete the questions below

#1 Full Legal Name: #1 Address: #1 Age: #1 If Minor, Full legal name of guardian or parent: #2 Full Legal Name: #2 Address: #2 Age: #2 If Minor, Full legal name of guardian or parent:

Child/Heir #7:

Yes

Full Legal Name: Address: Telephone Number: Date of Birth: Which of the following best describes the child’s relationship to you?

Naturally born, Adopted, Step-child

Is the child living or deceased?

If deceased, Date and location of death

If deceased, are there any living children?

If yes, please complete the questions below

#1 Full Legal Name: #1 Address: #1 Age: #1 If Minor, Full legal name of guardian or parent: #2 Full Legal Name: #2 Address: #2 Age: #2 If Minor, Full legal name of guardian or parent:

Child/Heir #8:

Yes

Full Legal Name: Address: Telephone Number: Date of Birth: Which of the following best describes the child’s relationship to you?

Naturally born, Adopted, Step-child

Is the child living or deceased?

If deceased, Date and location of death

If deceased, are there any living children?

If yes, please complete the questions below

#1 Full Legal Name: #1 Address: #1 Age: #1 If Minor, Full legal name of guardian or parent: #2 Full Legal Name: #2 Address: #2 Age: #2 If Minor, Full legal name of guardian or parent:

Other Pertinent Family Information or explanation of Above Items:

PERSONAL REPRESENTATIVE/EXECUTOR

Does the Will or any other communication from the Deceased indicated who should be Personal Representative (“executor”) of the Deceased’s estate?

(The Personal Representative is responsible for probating the Will, paying debts, collecting the assets, and settling the estate.)

Yes

SAFE DEPOSIT BOX

Did the Deceased have a Safe Deposit box?

Yes

PROFESSIONALS

Did the Deceased have an accountant?

Yes

Did the Deceased have a financial planner?

Yes

DECEASED'S ASSETS

Please list the Deceased’s Assets and approximate value.

For each Asset, please select "Yes" and complete the requested information. If it's not applicable, please select "No".

Asset #1:

Yes

Asset #2:

Yes

Asset #3:

Yes

Asset #4:

Yes

Asset #5:

Yes

Asset #6:

Yes

Asset #7:

Yes

Asset #8:

Yes

Asset #9:

Yes

Asset #10:

Yes

DECEASED'S LIABILITIES

Please list the Deceased’s Liabilities, account number, address and amount owed.

For each Liability, please select "Yes" and complete the requested information. If it's not applicable, please select "No".

Liability #1:

Yes

Liability #2:

Yes

Liability #3:

Yes

Liability #4:

Yes

Liability #5:

Yes

Liability #6:

Yes

Liability #7:

Yes

Liability #8:

Yes

Liability #9:

Yes

Liability #10:

Yes

QUESTIONS FOR YOUR ATTORNEY

Please make a list of pertinent questions you would like to ask your attorney:

e-Acknowledgement and Acceptance:

I certify that the information provided above is true, complete, and correct to the best of my knowledge.

PLEASE NOTE

INITIAL CONSULTATION CHARGES

There will be a charge for an initial consultation for this matter. Please be sure to ask any questions you have about fees and payment arrangements at your initial consultation.

Reduced Initial Consultation Rate (up to the first hour) ……. $225.00

After one hour the attorney’s normal hourly rate applies. Sales tax (6.2%) and costs, if any, are in addition to these amounts. If any other rates become applicable to your particular case, your attorney will discuss them with you.

Payment is due in full prior to your consultation.

PRIVACY POLICY NOTICE

Lawyers, like other professionals who advise on personal financial matters, are now required by a new federal law entitled the Gramm-Leach-Bliley Act to inform their clients of their policies regarding privacy of client information. Attorneys have always been and continue to be bound by professional standards of confidentiality that are even more stringent that those required by this new law. Therefore, we have always protected your right to privacy.

In the course of providing our clients with legal advice involving financial information of our clients, we receive significant personal Probate and Estate Planning for our clients. If you are a client of MONUMENT LAW, you should know that all information that we receive from you is held in strict confidence, and is not released to people outside the law firm, except as agreed to by you, or as required by law.

We retain records relating to professional services that we provide so that we are better able to assist you with your professional needs, and in some cases, to comply with professional guidelines. In order to guard your nonpublic personal information, we maintain physical, electronic, and procedural safeguards that comply with legal requirements to guard your nonpublic personal information and we maintain appropriate safeguards that comply with our professional standards.

If you have questions, please consult the attorney at the beginning of your consultation. Thank you.

Please indicate your preferred method of contact (this would include billing):

Telephone:

E-Mail:

Consent:

I hereby consent to electronic forms of communication such as e-mail.

THANK YOU

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