Living Trust Questionaire

Revocable Living Trust Questionaire

Thank you for selecting Fred Howe Law to assist you with your estate planning needs. Your decision to purchase the Fred Howe Law Revocable Living Trust policy will allow you to pass along your estate to your heirs without lawyers, courts or the probate system. A representative will be contacting you within the next few day to review your trust application, go over the specifics of your estate, and answer any questions you may have. Your trust will be completed and delivered to you in approximately 4-6 weeks. If you have questions regarding this process, get in touch with us via the Contact page and we will be happy to assist you.

State Your Full Name (First, Middle, Last):
State all other names by which you have been known:
Age:
Date of Birth:
Sex:
Street Address:
City:
County:
State:
Zip Code:
Home Phone:
Work Phone:
Cell Phone:
Other Contact:
Email
If married, state your spouses full name (including maiden name):
If you have children, state the Name, Sex, Date of Birth, and the type of relationship (i.e. Biological, Step, Adopted) for each child below:
List name, sex, and date of death of deceased child or children:
List name, sex, and date of birth of deceased childs living children:
Do you and your spouse have a Prenuptial Agreement, which identifies and disposes of separate spousal property?
Have you created any trusts or made gifts to any trusts? If yes, describe:
Do you have a date on which you expect to have any inheritance distributed to you? If so, state from whom and how much:
Please use the drop down menu below to indicate how you want your assets to pass when you die:
Option A: I want my assets to pass to my spouse and children as follows:
   - To spouse, if surviving.
   - If my spouse predeceases me, my assets will be divided in equal shares among my children.
   - If any of my children predecease me, that childs share shall be distribured to his or her children in equal shares.
   - In the event my spouse and all of my children and descendents fail to survive me, I want my assests to be distributed as follows (describe in box below):

Option B: I am unmarried with children and want my assets to pass:
   - In equal shares to my children.
   - If one or more of my children predeceases me, that childs share in my estate is distributed to his or her children in equal shares.
   - In the event all of my children and descendents fail to survive me, I want my assests to be distributed as follows (describe in box below):

Options C: None of the above
   - Describe how youd like your assets to pass in the box below.


At what age(s) do you want the monies to be distribured to your children/beneficiaries? List ages and percentages:
List any instructions regarding limitations on distributions (such as must finish college, etc.), or any special situations (such as starting a business, getting married, etc.):
Do you wish to disinherit any child, grandchild or other person? If yes, you must list their names below:
Many people make special provisions for family heirlooms, jewelry, or other items of special value to be distributed to friends or relatives. If you have such property and wish it left to a specific person, please list the item(s), special identifing features of the item(s), and the recipient(s) below:
Note: If you have chosen "Option A" or "Option B" above, you have indicated by your selection the items describeed above will pass to your spouse and/or children. Complete this question ONLY if you desire such items of specific value to be left to specific person(s).
If your children are under age eighteen (18), state the full name, address, and relationship (if any) of the persons you wish to act as their gaurdian (custody) in the event of your death (in the case of a single parent) or in case of the joint death of you and your spouse (if married). You should obtain the consent of the peron(s) before executing your Will.
Note: A gaurdian is a person lawfully invested with the power, and charged with the duty, of taking care of the person who is incapable of doing so because of age or other incapacity.
Guardian(s):
Name(s):

Address:

City:

County:

State:

Zip Code:

Relationship (if any):

Incase the person or entity listed above is unwilling or unable to serve as guardian, please list an alternative below:
Successor Guardian(s):
Name(s):

Address:

City:

County:

State:

Zip Code:

Relationship (if any):
If you want the guardian to receive a stipend/compensation for taking on the responsibilities of guardian (e.g. monthly, annually, COLA, salary reimbursement to stay at home, etc.), please set forth the details:
Do you want appointed guardian also to be the conservator of any assets inherited by the minor child(ren)?

If no, please list the person or entity you wish to act as their conservator. You should obtain the consent of that person or entity before executing your Will.
Conservator(s):
Name(s):

Address:

City:

County:

State:

Zip Code:

Relationship (if any):

Incase the person or entity listed above is unwilling or unable to serve as conservator, please list an alternative below:
Successor Conservator(s):
Name(s):

Address:

City:

County:

State:

Zip Code:

Relationship (if any):
If you want the conservator to receive a stipend/compensation for taking on the responsibilities of managing the trust assets (e.g. monthly, annually, COLA, etc.), please set forth the details:
Will / Pour-Over Will (with a trust)
The person charged with administering your estate, paying taxes and other debts, marshalling, preserving, managing and distributing estate assets and property is called personal representative (executor). State the name and address of the person to wish to serve in this role.
Would you like your spouse to be your personal representative (executor)?

Successor or if not spouse:
Primary Successor:
Name(s):

Address:

City:

County:

State:

Zip Code:

Relationship (if any):

Incase the person listed above is unwilling or unable to serve as a personal representative, please list an alternative below:
Second Successor:
Name(s):

Address:

City:

County:

State:

Zip Code:

Relationship (if any):
Do you wish to waive the fiduciary bond requirement (usually they serve without bond)?

Note: A fiduciary bond is a type of surety bond required by the court to be filed by executors, guardians, etc. to ensure proper performance of duties.
Trust / Childs Trust (with a will if there is minor children)
The person charged with administering your estate, paying taxes and other debts, marshalling, preserving, managing and distributing estate assets and property is called a trustee. State the name and address of the person to wish to serve in this role.
First Successor Trustee:
Name(s):

Address:

City:

County:

State:

Zip Code:

Relationship (if any):

Incase the person listed above is unwilling or unable to serve as a trustee, please list an alternative below:
Second Successor Trustee:
Name(s):

Address:

City:

County:

State:

Zip Code:

Relationship (if any):
Do you wish to waive the fiduciary bond requirement (usually they serve without bond)?

Note: A fiduciary bond is a type of surety bond required by the court to ensure proper performance of duties.
In what place and manner do you wish for your remains to be disposed of?

Note: Execution of a Will/Trust is the best way to determine how your property will be distributed; however, it cannot address important issues regarding health care decisions. You may want to discuss the functions of a Health Care Power of Attorney and a Living Will with our office. These issues should be discussed prior to drafting these documents with the person named as agent.
If you become incapacitated, would you like your spouse to make health care decisions for you?

Successor or if not spouse:
Primary/Successor Agent:
Name(s):

Address:

City:

County:

State:

Zip Code:

Phone Number:

Relationship (if any):

Incase the person listed above is unwilling or unable to serve as a personal representative, please list an alternative below:
Successor Agent:
Name(s):

Address:

City:

County:

State:

Zip Code:

Phone Number:

Relationship (if any):

Under Arizona law, the agent under your Health Care Power of Attorney has the ability to make mental health care decisions on your behalf. However, that agent does NOT have the ability to place you in a level one behavioral health care facility licensed by the Department of Health Services (a locked facility), in the event that you need to be in this type of facility. This document is especially recommended to those who have a family history of any mental illness (including Alzheimers disease).
Do you want a Mental Health Care Power of Attorney?
If yes, would you like your spouse to have the authority to make all mental health care decisions for you?

Successor or if not spouse:
Primary/Successor Agent:
Name(s):

Address:

City:

County:

State:

Zip Code:

Phone Number:

Relationship (if any):
Do you want a Living Will (life support decisions)?
If yes, would you like your spouse to be responsible for deciding to remove you from life support?

Successor or if not spouse:
Primary/Successor Agent:
Name(s):

Address:

City:

County:

State:

Zip Code:

Phone Number:

Relationship (if any):

Incase the person listed above is unwilling or unable to serve as a personal representative, please list an alternative below:
Successor Agent:
Name(s):

Address:

City:

County:

State:

Zip Code:

Phone Number:

Relationship (if any):
Here are some general statements about choices you have as to health care you want at the end of your life. Check whichever choices best fit your wishes. Any combination can be used but if you choose "Direction to Prolong My Life (to the greatest extent possible)", no other choices should be checked.
Comfort Care Only
If I have a terminal condition I do not want my life to be prolonged, and I do not want life-sustaining treatment, beyond comfort care, that would serve only to artificially delay the moment of my death. (NOTE: "Comfort care" means treatment in an attempt to protect and enhance the quality of life without artificially prolonging life.)
Specific Limitations on Medical Treatments I Want
(NOTE: Mark one or more choices below.) If I have a terminal condition, or am in an irreversible coma or a persistent vegetative state that my doctors reasonably believe to be irreversible or incurable, I do want the mideical treatment necessary to provide care that would keep me comfortable, but I do not want the following:
 Cardiopulmonary resuscitation. For example: the use of drugs, electric shock, and artificial breathing.
Artificially administered food and fluids.
To be taken to a hospital if it is at all avoidable.
Pregnancy
Regardless of any other directions I have given in this Living Will, if I am known to be pregnant I do not want life-sustaining treatment witheld or withdrawn if it is possible that the embryo/fetus will develop to the point of live birth with the continued application of life-sustaining treatment.
Treatment Until My Medical Condition is Reasonably Known
Regardless of the directions I have made in this Living Will, I do want the use of all medical care necessary to treat my condition until my doctors reasonably conlcude that my condition is terminal or is irreversible and incurable, or I am in a persistent vegetative state.
Direction to Prolong My Life
I want my life to be prolonged for a specific amount of time (specify in "Other Directions" box below).
Direction to Prolong My Life
I want my life to be prolonged to the greatest extent possible.
Other Directions
Do you wish to donate your organs for the following purposes?
Transplantations
 Research
 Studies

In addition to a Last Will and Health Care documents, many individuals ask to receive a General Durable Power of Attorney that becomes "EFFECTIVE UPON INCAPACITATION". This document allows an individuals designated "Attorney-In-Fact" to act for them in all financial matters during any time that the individual is incapacited due to medical or other problems. The Attorney-In-Fact will have full control over your financial future; therefore, you need to make sure only to select trustworhy individuals to act in such an important capacity for you.
Do you want a General Durable Power of Attorney?
If yes, would you like your spouse to be your Attorney-In-Fact?

Successor or if not spouse:
Successor/Primary Attorney-In-Fact:
Name(s):

Address:

City:

County:

State:

Zip Code:

Phone Number:

Relationship (if any):

Incase the person listed above is unwilling or unable to perform these duties, please list an alternative below:
Successor Attorney-In-Fact:
Name(s):

Address:

City:

County:

State:

Zip Code:

Phone Number:

Relationship (if any):
If there is any other information you think would help us prepare your Will, please include it below:
Additional Comments or Information:


Please double-check the entire form before submitting.