Estate Planning Questionnaire
Estate Planning Questionnaire
Estate Planning Questionnaire
In an effort to show our appreciation for the daily sacrifices of fire fighters, police officers and other first
responders, this free program is brought to you by the Arizona Foundation for Legal Services and Education in
partnership with the State Bar of Arizona. The Wills for Heroes program offers free Wills, Living Wills and Health
and Financial Powers of Attorney to Arizona’s first responders and their spouse/partner.
The complimentary Wills we offer, however, are not for everyone. To enable us to offer these estate planning
documents to all Arizona police officers, fire fighters and other first responders efficiently and at no cost, the Wills
do not cover many issues for persons with large or complicated estates, beneficiaries with special needs, and
beneficiaries that cannot handle finances. The program also is not appropriate for persons who want to set up or
require sophisticated Trusts. As defined in the Wills for Heroes program, a large estate exceeds $750,000.
Your estate (for Wills for Heroes purposes) consists of your cash, personal property, stock and bonds, real estate
(equity only), savings, life insurance (only include the cash value of a whole life policy – do not include term life
insurance, even though term life insurance may have value in the secondary market), inheritances (only
inheritances you have already received; do not count it if the inheritance is in trust for your benefit or if it is
expected in the future) and retirement assets like a 401(k) or an IRA. If you have a large or complicated estate or
desire complex Trust arrangements, this program is not available to you. You should instead contact a lawyer who
focuses in the area of Wills and Trusts.
Wills for Heroes does not handle beneficiary designations on any assets. For example, if you designated a
beneficiary(ies) in your life insurance policy, they will receive their benefit without it passing through your Will.
On the other hand, life insurance policies where the beneficiary is not designated, or where you name your estate
as the beneficiary, will pass through your Will when you die. The same principle applies to IRAs, retirement plans,
annuities and 401(k) plans. You should check with your provider every one to two years to make sure the
beneficiary designations are correct and current.
Additionally, Wills for Heroes does not handle the following areas / issues: 1) estate, gift, income and / or
Generation Skipping Transfer tax issues; 2) special needs trusts; 3) charitable trusts; 4) citizenship / domicile of
first responder and / or spouse; 5) assets managed by a fiduciary outside of the U.S.; 6) assets held outside of the
U.S; 7) short term and / or long term care planning; 8) immigration issues; and 9) any litigation matter. The
program also does not handle complicated or intricate planned distributions outside of the questionnaire options.
No lawyer or law firm involved in the Wills for Heroes program has performed a conflict search on your name or
your spouse or partner’s name; therefore, if you are aware of any legal proceeding involving you, please alert the
attorney at the beginning of the interview so that the attorney will arrange for another attorney to meet with you.
This questionnaire will answer some common questions and prepare you to discuss your needs with an attorney.
It will also provide a convenient form to record your important information. All discussions with an attorney will
be kept confidential. You will keep your questionnaire at the end of the appointment. The Wills for Heroes program
does not keep a copy of your Will or other estate planning documents; it will be up to you to keep your original
documents in a safe and fireproof place. This questionnaire will also help you organize information that the
attorney needs to advise you and prepare your estate plan. Some individuals need complex plans that may need
assistance beyond what is available in this program. The attorney assigned to work with you will advise you if it
is necessary in your case.
You and your spouse will have separate appointments with different attorneys to avoid potential conflicts
of interest. Each spouse or partner must fill out and bring with him / her a separate estate planning questionnaire,
even though the questionnaires may be similar to the other. Please bring your completed questionnaire with you
to the Wills Day along with a government-issued form of identification.
ESTATE PLANNING QUESTIONNAIRE
VALUE OF YOUR ESTATE: Please estimate the value of your estate. Wills for Heroes includes those with an
estate of $750,000 or less. Those with an estate in excess of $750,000 are not eligible for this program.
To determine the value of your estate, include only the following: cash, personal property, stock and bonds,
real estate (equity only), savings, life insurance (term life insurance does not count towards the value of your
estate; count only the cash value of any whole life policy) and retirement assets (401(K) or an IRA.)
For the purpose of discussing your assets with an attorney in this program, include below the value of all of the
property you own in your name, and if married and acquired the property during your marriage, the value of the
property jointly owned by the two of you. If you acquired the property before you were married, or by inheritance,
and you have kept this asset in your individual name, please list it as an asset of your estate. Life insurance
ordinarily does not pass according to your Will; it will go to the beneficiaries you designate in the policy. The
same typically applies to IRAs, 401(k), 403(b) and other retirement plans.
Life Insurance (cash surrender value only; do not include term life insurance here):
Vehicles:
Business Interests:
Pension Benefits that continue after your death; these benefits are paid to:
1. PERSONAL INFORMATION:
3. MILITARY SERVICE:
If yes, then the following paragraph will be added to the powers clause in your Will:
I have served in the Armed Forces of the United States. I therefore request that my personal
representative make appropriate inquiries to ascertain whether there are any benefits to which I,
my dependents or heirs may be entitled by virtue of any military affiliation. I specifically request
that my personal representative consult with a retired affairs officer at the nearest military
installation, the Department of Veterans Affairs, and the Social Security Administration .
4. CHILDREN:
Do you have any children living or deceased? Yes No
Please list all of your children's names, dates of birth, and whether they are biological or adopted:
Name DOB Biological/Adopted Name DOB Biological/Adopted
The above does not include step-children, if any. If you wish to provide for step-children, they can be listed in the
distribution Article, but are not listed here unless they have been adopted.
Do you wish to include in the definition of “my children” any children you may have biologically or adopt in the
future? Yes No
Is any child a minor? Yes No (If “yes”, be sure to complete Items 9 and 13)
If Yes, is the other parent of the minor child(ren) alive? Yes No
The other parent of the minor child(ren) is: My Spouse Another Person
If the other parent of the minor child(ren) is another person, list below:
Name Other Parent Name Other Parent
5. STEPCHILDREN:
If you provide for step-children in your Will, then checking the box “yes” will include a paragraph in your Will that
says you are providing for the step-child regardless of whether you are married to the step-child’s parent or not at
your death. If you check no, the stepchildren paragraph will not be included.
Do you have any stepchildren? Yes No. If yes, please list them below:
6. DISINHERITING SOMEONE:
If so, who (please provide the name, gender and relationship to you)?
If you wish to disinherit your spouse, you will need to discuss this further with your attorney. This issue is not handled
in this program. Please realize that Arizona provides statutory allowances for your spouse at your death, even if
disinherited or legally separated.
Your court appointed Personal Representative (in other states called the “executor”) makes sure your estate is
settled upon your death. This ordinarily involves going through probate, a court-administered procedure for
settling an estate as provided in your Will or under State law. Probate involves petitioning a court for letters of
appointment, settling creditor claims, finding and distributing assets, and filing any necessary tax returns. Any
competent adult may serve as your Personal Representative. Personal Representatives have a duty not only to the
beneficiaries but also to the creditors of the estate.
My spouse/partner.
Another individual. Please name:
Do you want to have a co-Personal Representative? Yes No This option is not usually recommended
because conflicts can arise between the Personal Representatives which will complicate the administration of your
estate.
Do you want a successor Personal Representative if the first Personal Representative(s) named is/are unable to act?
Yes No The successor will act only if your first choice is unable to be your Personal Representative.
Do you want to have someone serve as a co-Personal Representative with this successor Personal Representative?
Yes No. This option is not usually recommended because conflicts can arise between the Personal
Representatives which will complicate the administration of your estate.
8. BOND REQUIREMENT:
This provision means that the Personal Representative must file a credit application with a bond agency. If the
Personal Representative (the “fiduciary”) steals assets from the estate, the bond agency replaces what was stolen
up to the amount of the bond. Depending upon the size of the estate, bonds can be very expensive. People often
do not require bond for the following reasons:
1. The person trusts that the person named as fiduciary would never steal from the estate’s assets;
2. The person does not want the estate to pay the expense of the bond; and
3. Having named the same person as beneficiary and fiduciary, the person does not see the need for the
bond.
People that require bond usually do so as an extra security measure if there are multiple beneficiaries, the person
does not know the fiduciary very well or the person does not trust the fiduciary.
If your children are minors (under age 18) when you die, and if the other natural/adopted parent is not alive or for any
reason cannot act as guardian, the court may appoint the person(s) you name to act as legal guardian(s) of your minor
children. The individual(s) named will have physical control and custody of the children until they reach 18. If you
have sole custody, upon your death, the child’s other natural or adopted parent will presumptively act as parent even
if you provide for someone else to serve as guardian in your Will. You should still name a guardian, however, in case
the child’s other natural or adopted parent dies before you, is unwilling to act as parent, cannot be located or for any
reason cannot act as guardian.
If you choose to appoint a guardian, please list their name, city, state of their residence:
Guardian:
If you choose to appoint a successor or co-guardian, please list each name, city, state of their residence:
A specific bequest is a statement in the Will that a certain asset or specific amount of money will be given to
beneficiary(ies). You may make specific gifts of cash, real estate, or tangible personal property to specific people
or charities within your Will. However, these bequests will be distributed first and may deplete your estate. Also,
specific bequests lapse (become null and void) if the property given cannot be found at your death. Therefore, if
you make specific bequests, only give property or amounts of cash that you are reasonably sure you will have when
you die. If you make no specific bequests, all of your property will pass to your primary beneficiaries, or what we
call residuary beneficiaries.
There are four different categories of specific bequests: car, cash, real estate, and tangible personal property. Below
please select what kind of specific bequest you want to make.
B) Cash: $
Name and relationship:
C) Real Estate: If you wish to make a specific bequest of real property, please bring copies of your real estate
deed, that put the property into your name. In addition, if the legal description is not typed, please ask
your title insurance agency customer service to pull a prior deed so that you can have a good legal
description to bring with you. Please realize that there are ways to hold real property so that it does not
pass according to your Will; it might be advisable to consult an attorney on these issues.
Frequently, a husband and wife own real estate jointly with right of survivorship or as community property with right
of survivorship. If you and your spouse own your home or other property that way, your Will does not affect how
your ownership interest passes when you die; it will go to the survivor.
IF your real estate does not automatically pass to your spouse/partner or another person upon your death, how do you
wish to give your real estate under your Will?
All to my spouse/partner.
To pass with the remainder of my estate (this is called the residuary clause).
My home to my spouse/partner and the rest of my real estate to pass with the rest of my estate.
* Remember to please bring copies of your real estate deeds to your appointment.
My spouse. If my spouse is not living upon my death, the item(s) shall be distributed to my issue per stirpes.
“Issue per stirpes” means that your bequest will follow each particular child’s bloodline.
My spouse. If my spouse is not living upon my death, the item(s) shall be distributed to my then-living children.
My spouse. If my spouse is not living upon my death, the item(s) shall be distributed to another individual(s)
Please name the other individual or individuals:
My spouse. If my spouse is not living upon my death, the item(s) shall be distributed to a named charity. Please
name the other charity or charities:
My then living children. If I have no living children, the item(s) shall be distributed to my then living
grandchildren
My then living children. If I have no living children, the item(s) shall be distributed to other named
individuals or charities. Please name the other individual or charity:
My issue per stirpes. (“Issue per stirpes” means that your bequest will follow each particular child’s bloodline.)
A class. Please describe (ie. My nieces and nephews, my grandchildren, etc.) (Note: a “class”
includes all individuals in the group you describe unless you specifically omit a person or persons.)
Named individual(s). If the named individual(s) is/are not living upon my death, the item(s) shall be
distributed to another named individual or individuals.
My spouse. If my spouse is not living upon my death, the item(s) shall be distributed to my issue per stirpes.
“Issue per stirpes” means that your bequest will follow each particular child’s bloodline.
My spouse. If my spouse is not living upon my death, the item(s) shall be distributed to my then living children.
My spouse. If my spouse is not living upon my death, the item(s) shall be distributed to my then living
grandchildren.
My spouse. If my spouse is not living upon my death, the item(s) shall be distributed to another individual(s)
Please name the other individual or individuals:
My spouse. If my spouse is not living upon my death, the item(s) shall be distributed to a named charity. Please
name the other charity or charities:
My then living children. If I have no living children, the item(s) shall be distributed to my then living
grandchildren
My then living children. If I have no living children, the item(s) shall be distributed to other named
individuals or charities. Please name the other individual or charity:
My issue per stirpes. (“Issue per stirpes” means that your bequest will follow each particular child’s bloodline.)
A class. Please describe (ie. My nieces and nephews, my grandchildren, etc.) (Note: a “class”
includes all individuals in the group you describe unless you specifically omit a person or persons.)
Named individual(s). If the named individual(s) is/are not living upon my death, the item(s) shall be
distributed to another named individual or individuals.
Please name the other individual(s):
How do you wish to give the remainder of your estate? Your residuary estate is whatever property remains after
paying debts and expenses of administration, and any specific bequests. Because many people do not make specific
bequests, the "residuary" usually describes all the property left to your primary beneficiaries.
If you designate a charity, we need to know its address and if it has non-profit status with the IRS.
My spouse. If my spouse is not living upon my death, the item(s) shall be distributed to my issue per stirpes.
“Issue per stirpes” means that your bequest will follow each particular child’s bloodline.
My spouse. If my spouse is not living upon my death, the item(s) shall be distributed to my then living children.
My spouse. If my spouse is not living upon my death, the item(s) shall be distributed to my then living grandkids.
My spouse. If my spouse is not living upon my death, the item(s) shall be distributed to another individual(s)
Please name the other individual or individuals:
My spouse. If my spouse is not living upon my death, the item(s) shall be distributed to a named charity.
Please name the other charity or charities:
My then living children. If I have no living children, the item(s) shall be distributed to my then living grandkids.
My then living children. If I have no living children, the item(s) shall be distributed to other named
individuals or charities. Please name the other individual or charity:
My issue, per stirpes. (“Issue per stirpes” means that your bequest will follow each particular child’s bloodline)
A class. Please describe (ie. My nieces and nephews, my grandchildren, etc.) (Note: a “class”
includes all individuals in the group you describe unless you specifically omit a person(s)
Named individual(s). If the named individual(s) is/are not living upon my death, the item(s) shall be
distributed to another named individual or individuals.
If any of your beneficiaries is a minor, at what age do you want them to receive their gift?
NOTE: When funds are held for a child until a specific age (18-21), a standard provision is included so that the
Personal Representative will act as Trustee over that child’s share until that child reaches your selected age. This
individual will be permitted to make distributions to the guardian, or maybe to the child personally when he/she
turns age eighteen (18), for the health, maintenance and education of the child.
Selecting an age greater than 21 requires a trust, which is outside the scope of this program.
The General Durable Power of Attorney (sometimes called Financial Power of Attorney) will allow the agent you
designate to handle your assets in case you are unable to do so. The General Durable Power of Attorney does not
deal with gifting issues, tax planning, long term care planning, payment of fees to your agent, etc. If you want a
General Durable Power of Attorney effective immediately, rather than on incapacity, or want to address any of the
above-mentioned issues, please seek legal advice outside of this program.
Would you like a general power of attorney? Yes No If No, you’re finished!
If someone other than your spouse/partner is your agent or your spouse/partner has a different address than yours,
please provide the following information:
Do you want a successor Agent if the first named Agent is unable to act? Yes No
The successor will act only if your first choice is unable to be your Agent. If yes, please provide the following
information:
Another important document is a power of attorney for health care. You may execute this in addition to your living
will. The Health Care POA appoints someone you name to make medical care decisions for you if you cannot
make your own medical decisions. It applies to more situations than the living will, which was discussed above.
The Health Care POA gives the person you name as your agent the authority to make a wide range of medical
decisions on your behalf. Your agent, once you are unable to communicate your wishes, is given the power to act
on your behalf to make health and mental health decisions (outside of a locked facility) It also gives your agent
access to your medical information and authority to fully participate with your treating physicians in deciding the
care you receive. Obviously, the person you designate to be your agent should be someone you trust with life and
death decisions and who you believe will follow your instructions.
If you selected someone other than your spouse/partner to act as your agent or you selected your spouse/partner to be
your agent and your spouse/partner has a different address than yours, please provide the following information:
Do you want a successor agent if the first named agent is unable to act? Yes No. The successor will act
only if your first choice is unable to be your Agent. If yes, please provide the following information:
FINAL ARRANGEMENTS:
I wish to be buried
I wish to be cremated
Final arrangements have not been decided
A living will (sometimes called “advance healthcare directive”) is separate from your Will and may be an important
part of your estate plan. It states that in the event you have a terminal, incurable medical condition and your life
is only being prolonged by means of artificially provided life support, and if you cannot communicate your desires,
the living will “speaks for you” so your doctors know and can act upon, your desires about medical life support.
Once executed, the document is effective until you revoked it, which you may do at any time by physically
destroying it or revoking it:
IF YOU DO NOT WANT A LIVING WILL, ONE WILL GENERATE ANYWAY WITH LANGUAGE THAT
ESSENTIALLY STATES YOU WANT TO LIVE AS LONG AS POSSIBLE.
If you DO want a Living Will, the following statements are part of it:
I DO WANT the use of all medical care necessary and available to treat my condition until or unless
my doctors reasonably conclude that my condition is terminal or irreversible and incurable or I am in
a persistent vegetative state.
Choose the statements below that you agree with by checking them off; if you do not check a statement, it will
not appear in your document:
Once my doctors determine that I am in a terminal condition or an irreversible coma or a persistent vegetative state
that my doctors reasonably feel to be irreversible or incurable, the following are my wishes (CHOOSE ALL THAT
APPLY):
I want to stay at home for any care that can be provided there.
I want to receive medication for terminal suffering, even if it hastens the moment of (but not intentionally
causes) my death.