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ESTATE PLANNING WORKSHEETBARKLEY T. MILLERAttorney & Counselor12900 Preston Road, Suite 325Dallas, Texas rkleymiller@sbcglobal.netInformation RequestedWIFEHUSBANDFull Legal Name:Name Normally Used:Texas County of Residence:CountySameResidence Address:Street AddressCity, State & Zip CodeTelephone:Home:Cell:SameEmail Address:Occupation:Name of Employer:Employer’s Address:Street AddressCity, State & Zip CodeStreet AddressCity, State & Zip CodeBusiness Telephone:Date of Birth:Citizenship:U.S./Other:U.S./Other:Estate Planning Worksheet- Page 1 of 14
YOUR CHILDREN(1)Full Legal Name:Name Normally Used:Residence Address:Street AddressCity, State & Zip CodeTelephone:Home:Cell:Work:Email Address:Date of Birth:Place of Birth:Born or Adopted:(Born)[Please Check One] (Adopted)Names of Parents:(2)Full Legal Name:Name Normally Used:Residence Address:Street AddressCity, State & Zip CodeTelephone:Home:Cell:Work:Email Address:Date of Birth:Estate Planning Worksheet- Page 2 of 14
Place of Birth:Born or Adopted:(Born) [Please Check One]Names of Parents:Full Legal Name:Name Normally Used:Residence Address:Street AddressCity, State & Zip CodeTelephone:Home:Cell:Work:Email Address:Date of Birth:Place of Birth:Born or Adopted:(Born)[Please Check One]Names of Parents:(Adopted)(3)(Adopted)(4)Full Legal Name:Name Normally Used:Residence Address:Street AddressCity, State & Zip CodeTelephone:Home:Cell:Work:Email Address:Estate Planning Worksheet- Page 3 of 14
Date of Birth:Place of Birth:Born or Adopted:(Born)[Please Check One] (Adopted)Names of Parents:[IF YOU HAVE MORE CHILDREN, PLEASE LIST THEM ON THE REVERSE OF THIS SHEET OF PAPER WITH THESAME INFORMATION REQUESTED FOR YOUR CHILDREN, ABOVE. THANK YOU!]MARITAL HISTORYDate of Your Marriage:Month, Day, and YearPremarital or Marital Agreement?(Yes)[Please Check One] (No)[If Yes, please furnish me a Copy]Wife Previously Married?(Yes)Full Legal Name of Former Spouse:Terminated by:(Death) [Please Check One] (Divorce)Date of Death or Divorce:Husband Previously Married?(Yes)Full Legal Name of Former Spouse:Terminated by:(Death) [Please Check One] (Divorce)Date of Death or Divorce:[Please Check One] (No)[Please Check One] (No)LAST WILLS AND TESTAMENTS: INDEPENDENT EXECUTORName of First Choice:Other SpouseName of Second Choice:Relationship to You:Residence Address:Street AddressEstate Planning Worksheet- Page 4 of 14
City, State & Zip CodeTelephone:Home:Cell:Work:Email Address:Name of Third Choice:Relationship to You:Residence Address:Street AddressCity, State & Zip CodeTelephone:Home:Cell:Work:Email Address:Name of Fourth Choice:Relationship to You:Residence Address:Street AddressCity, State & Zip CodeTelephone:Home:Cell:Work:Email Address:LAST WILLS AND TESTAMENTS:TRUSTEE OF CONTINGENT TRUST*Name of First Choice:Relationship to You:Residence Address:Estate Planning Worksheet- Page 5 of 14
Street AddressCity, State & Zip CodeTelephone:Home:Cell:Work:Email Address:Name of Second Choice:Relationship to You:Residence Address:Street AddressCity, State & Zip CodeTelephone:Home:Cell:Work:Email Address:Name of Third Choice:Relationship to You:Residence Address:Street AddressCity, State & Zip CodeTelephone:Home:Cell:Work:Email Address:Name of Fourth Choice:Relationship to You:Residence Address:Street AddressEstate Planning Worksheet- Page 6 of 14
Telephone:City, State & Zip CodeHome:Cell:Work:Email Address:* A contingent trust for a beneficiary, such as a child or grandchild, is a means by which toset aside probate assets for that beneficiary until he or she attains a certain age, certainages, or for the beneficiary’s lifetime.For example, you may provide that your Estate passes to any such beneficiary all afterattaining a certain age (e.g., all at age 25, 30, 35 ,etc.), or in fractional shares (e.g., 1/3 atage 21, ½ of the balance at age 25, and the remainder at age 30).What type of contingent trust age or ages of distribution do you wish (i.e., when do youwant the Contingent Trust to terminate)LAST WILLS AND TESTAMENTS:GUARDIAN OF THE PERSON(S) OF YOUR MINOR CHILD(REN)**Persons Other Than Your Spouse as GuardianName of First Choice:Relationship to You:Residence Address:Street AddressCity, State & Zip CodeTelephone:Home:Cell:Work:Email Address:Name of Second Choice:Estate Planning Worksheet- Page 7 of 14
Relationship to You:Residence Address:Street AddressCity, State & Zip CodeTelephone:Home:Cell:Work:Email Address:Name of Third Choice:Relationship to You:Residence Address:Street AddressCity, State & Zip CodeTelephone:Home:Cell:Work:Email Address:Name of Fourth Choice:Relationship to You:Residence Address:Street AddressCity, State & Zip CodeTelephone:Home:Cell:Work:Email Address:Estate Planning Worksheet- Page 8 of 14
DISPOSITION OF YOUR ESTATEWIFEAll to Husband; and if Husband Predeceases, All to Child (ren) (In Equal Shares) (subject to ContingentTrust, if applicable)ORHUSBANDAll to Wife; and if Wife Predeceases, All to Child (ren) (In Equal Shares) (subject to Contingent Trust, ifapplicable)ORDISPOSITION IN THE EVENT OF A COMMON DISASTERWIFEHUSBANDEstate Planning Worksheet- Page 9 of 14
WILL CONTEST PROVISIONSYou should consider adding Will Contest Provisions to your Last Wills and Testaments if you arecontemplating disinheriting a family member who is in the legal line of descent, such as a child(ren),sibling(s), parent(s), etc., or leaving any such individual less than an equal share of your Estate.Do you wish to have a Will Contest Provision in your Last Wills and Testaments?Wife:Husband:YesYes[Please Check One][Please Check One]NoNoSTATUTORY DURABLE POWERS OF ATTORNEYWIFEName of First Choice:HusbandName of Second Choice:Relationship to You:Residence Address:Street AddressCity, State & Zip CodeTelephone:Home:Cell:Work:Email Address:Name of Third Choice:Relationship to You:Estate Planning Worksheet- Page 10 of 14
Residence Address:Street AddressCity, State & Zip CodeTelephone:Home:Cell:Work:Email Address:Name of Fourth Choice:Relationship to You:Residence Address:Street AddressCity, State & Zip CodeTelephone:Home:Cell:Work:Email Address:HUSBANDName of First Choice:WifeName of Second Choice:Relationship to You:Residence Address:Street AddressCity, State & Zip CodeTelephone:Home:Cell:Work:Email Address:Name of Third Choice:Estate Planning Worksheet- Page 11 of 14
Relationship to You:Residence Address:Street AddressCity, State & Zip CodeTelephone:Home:Cell:Work:Email Address:Name of Fourth Choice:Relationship to You:Residence Address:Street AddressCity, State & Zip CodeTelephone:Home:Cell:Work:Email Address:DIRECTIVES TO PHYSICIANS AND FAMILY OR SURROGATES,MEDICAL POWERS OF ATTORNEY, AND HIPPA AUTHORIZATIONSWIFEName of First Choice:HusbandName of Second Choice:Relationship to You:Residence Address:Street AddressCity, State & Zip CodeEstate Planning Worksheet- Page 12 of 14
Telephone:Home:Cell:Work:Email Address:Name of Third Choice:Relationship to You:Residence Address:Street AddressCity, State & Zip CodeTelephone:Home:Cell:Work:Email Address:Name of Fourth Choice:Relationship to You:Residence Address:Street AddressCity, State & Zip CodeTelephone:Home:Cell:Work:Email Address:HUSBANDName of First Choice:WifeName of Second Choice:Relationship to You:Residence Address:Street AddressEstate Planning Worksheet- Page 13 of 14
City, State & Zip CodeTelephone:Home:Cell:Work:Email Address:Name of Third Choice:Relationship to You:Residence Address:Street AddressCity, State & Zip CodeTelephone:Home:Cell:Work:Email Address:Name of Fourth Choice:Relationship to You:Residence Address:Street AddressCity, State & Zip CodeTelephone:Home:Cell:Work:Email Address:Estate Planning Worksheet- Page 14 of 14
Estate Planning Worksheet- Page 1 of 14 ESTATE PLANNING WORKSHEET BARKLEY T. MILLER Attorney & Counselor 12900 Preston Road, Suite 325 Dallas, Texas 75230-1364 Telephone: 972-934-0178 Fax: 972-934-0179 barkleymiller@sbcglobal.net Information Requested WIFE HUSBAND Full Legal Name: _ _ .
