Client Data Input Form
Please answer the following questions as accurately and as completely as possible. If any question does not apply to you, please simply indicate "not applicable". Also, please note that should you wish to leave property to someone who is not your spouse or child, please input their data in the spaces provided for children and indicate their relationship to you in parentheses after their name(s).
What is your full name?
What is your maiden name?
What is your Social Security Number?
What is your current home address?
What is your current home telephone number?
What is your date of birth?
What is your place of birth?
What is your citizenship?
What is your spouse’s name?
What is your spouse’s maiden name?
What is your spouse’s Social Security Number?
What is your spouse’s current home address?
What is your spouse’s current home telephone number?
What is your spouse’s date of birth?
What is your spouse’s place of birth?
What is your spouse’s citizenship?
What is your date of marriage?
What is your place of marriage?
What is the name of your former spouse?
What is the date and place of your former marriage?
What is the date, place and cause of the termination of your former marriage?
What is the name of your first child?
What is the date of birth of your first child?
What is the place of birth of your first child?
What is the name of your first child’s spouse?
What is your first child’s address?
What is your first child’s Social Security Number?
What is the name of your second child?
What is the date of birth of your second child?
What is the place of birth of your second child?
What is the name of your second child’s spouse?
What is your second child’s address?
What is your second child’s Social Security Number?
What is the name of your third child?
What is the date of birth of your third child?
What is the place of birth of your third child?
What is the name of your third child’s spouse?
What is your third child’s address?
What is your third child’s Social Security Number?
What is the name of your fourth child?
What is the date of birth of your fourth child?
What is the place of birth of your fourth child?
What is the name of your fourth child’s spouse?
What is your fourth child’s address?
What is your fourth child’s Social Security Number?
What is the name of your fifth child?
What is the date of birth of your fifth child?
What is the place of birth of your fifth child?
What is the name of your fifth child’s spouse?
What is your fifth child’s address?
What is your fifth child’s Social Security Number?
What is the name, age, address and relationship to you of any person that you do not want to leave property to under your will, if any?
Do you believe that this person would contest your wishes as expressed in your will?
If you believe that this person would contest your wishes as expressed in your will, would you be willing to leave a small amount of property to this person provided that this person would lose the property should they contest your will?
What is the general nature of your estate?
If you own your own residence, how is it titled?
What is its value?
If you own other real estate, how is it titled?
What is its value?
Do you own any real estate outside of Texas?
If you own real estate other than in Texas, where is it located?
If you own a vehicle, how is it titled?
What is its value?
If you own a recreation vehicle, how is it titled?
What is its value?
What livestock do your own?
What is its value?
What other personal property do you own?
What is its value?
What life insurance policies do you own on your life?
What is the value of these policies?
Who is the present primary beneficiary?
Who is the present secondary beneficiary?
What life insurance policies do you own on your spouse’s life?
What is the value of these policies?
Who is the present primary beneficiary?
Who is the present secondary beneficiary?
What benefit plan do you currently own?
What is its value?
Who is the present primary beneficiary?
Who is the present secondary beneficiary?
Do you own any property as joint tenants with right of survivorship [JTWROS] with your spouse or any other person?
If you do own property as JTWROS, what is the name of the other joint owner(s)?
What specific assets, of those listed above, do you want to leave to specific individuals under your will, if any?
What liabilities do you currently pay on?
What is your present total indebtedness?
What is the name, age, address and relationship to you of the person that you wish to have serve as Executor?
What is the name, age, address and relationship to you of the person that you wish to have serve as alternate Executor?
If you wish to create a testamentary trust, what is the name, age, address and relationship to you of the person that you wish to have serve as Trustee?
If you wish to create a testamentary trust, what is the name, age, address and relationship to you of the person that you wish to have serve as alternate Trustee?
In your owns words, briefly describe the way in which you want your property to pass under your will if your spouse survives you?
In your owns words, briefly describe the way in which you want your property to pass under your will if your spouse does not survive you?
If you wish to have a Financial Power of Attorney prepared, what is the name, age, address and relationship to you of the person that you wish to have serve as your Attorney in Fact should you become incapacitated?
If you wish to have a Financial Power of Attorney prepared, what is the name, age, address and relationship to you of the person that you wish to have serve as your alternate Attorney in Fact should you become incapacitated?
If you wish to have a Healthcare Power of Attorney prepared, what is the name, age, address and relationship to you of the person that you wish to have serve as your Attorney in Fact should you become incapacitated?
If you wish to have a Healthcare Power of Attorney prepared, what is the name, age, address and relationship to you of the person that you wish to have serve as your Attorney in Fact should you become incapacitated?
If you wish to have a Directive to Physician prepared, do you wish to have all means available utilized to sustain your life?
If you wish to have a Directive to Physician prepared, do you wish to have all means available to sustain your life withheld?
If you wish to have a Declaration of Guardianship prepared, what is the name, age, address and relationship to you of the person that you wish to have serve as Guardian of your Person should you become incapacitated?
If you wish to have a Declaration of Guardianship prepared, what is the name, age, address and relationship to you of the person that you wish to have serve as alternate Guardian of your Person should you become incapacitated?
If you wish to have a Declaration of Guardianship prepared, what is the name, age, address and relationship to you of the person that you wish to have serve as Guardian of your Estate should you become incapacitated?
If you wish to have a Declaration of Guardianship prepared, what is the name, age, address and relationship to you of the person that you wish to have serve as alternate Guardian of your Estate should you become incapacitated?
If you wish to have an Appointment of Guardianship over Minor Children prepared, what is the name, age, address and relationship to you of the person that you wish to have serve as Guardian over Your Minor Child should you pass away or become incapacitated?
If you wish to have an Appointment of Guardianship over Minor Children prepared, what is the name, age, address and relationship to you of the person that you wish to have serve as alternate Guardian over Your Minor Child should you pass away or become incapacitated?
If you wish to have a Disposition of Remains prepared, in what manner do you wish for your remains to be disposed of after you have passed away?