Estate Planning Worksheet

Thank you for selecting Hoopes Adams & Alexander to assist you in your estate planning efforts. We look forward to help you design a plan that meets your objectives.

After you complete the information below to the best of your ability, you can either:

email it to us (by clicking "Submit") or
print and fax it to us at 480-345-8828.

Sending us this information at least three days before our appointment will help us be prepared to advise you.

Full Name (the name you use to title property and accounts)

Preferred Name

Date of Birth

Social Security #

U.S. Citizen?

Home Address

City

State

Zip

Home Phone

Cell Phone

Work Phone

Marital Status

If Married, Date of Marriage

Spouse's Full Name

Spouse's Preferred Name

Date of Birth

Social Security #

U.S. Citizen?

Home Address (if different than above)

City

State

Zip

Home Phone

Cell Phone

Work Phone

Children's Names	Birth Date	Child of

Your Accountant		Phone

Your Financial Advisor		Phone

Your Life Insurance Agent		Phone

	Husband	Wife
Do you have a will, trust or other estate planning documents?**
Are you making payments per a divorce or property settlement?**
If married, have you signed a pre- or post-marriage contract?**
Do you or any beneficiaries have health problems or special needs?
Do you own a business?
Do you own a long-term care insurance policy?
Do you own any property that is not community property?
Have you ever filed federal or state gift tax returns?**
Do you wish to support charitable organizations after your death?
Are you currently the beneficiary of anyone else's trust?
**Bring copies to your appointment

Income/Month	Husband	Wife	Joint
Earned Income	$	$	$
Social Security	$	$
Pensions	$	$
Other	$	$	$

Real Property

Parcel 1:
How Owned:
Value:	$
Equity:	$

Parcel 2:
How Owned:
Value:	$
Equity:	$

Parcel 3:
How Owned:
Value:	$
Equity:	$

Parcel 4:
How Owned:
Value:	$
Equity:	$

Personal Property
The value of your major personal effects,
e.g., jewelry, collections, antiques, etc.:

Cash in the Bank

Checking:	$
Checking:	$
Money Market:	$
Other:	$
Other:	$

Stocks and Bonds: Current Market Value

	Husband	Wife
401(k)	$	$
IRA:	$	$
Roth IRA:	$	$
Pension:	$	$
Other:	$	$
Cash Value of Life Insurance:	$	$

Insurance Policies and Annuities: Death Benefit

	Husband	Wife
Life Insurance:	$	$
Life Insurance:	$	$
Group Life:	$	$
Annuity:	$	$
Annuity:	$	$

Business Interests		Entity	Owner	% Owned
1:	$
2:	$
3:	$

Other Assets

	$
	$
	$
	$

If you prefer not to send your information via the Internet, simply print this page and fax it to Ron Adams at 480-345-8828.