Jaspers Moriarty & Walburg, P.A.



Attorneys At Law

206 Scott Street
Shakopee, MN 55379
Phone: (952) 445-2817
Fax: (952) 445-0812

206 Scott Street, Shakopee, MN 55379, Phone: (952) 445-2817, Fax: (952) 445-0812,
Email: kwetherille@jmwlaw.com

ESTATE PLANNING INFORMATION

Name:

Address:

Occupation:

County of Residence:

Social Security Number:

D.O.B:

Place of Birth:

Name of Spouse:

Telephone number:

Email Address:

Names of heirs; if minor children exist; include date of births:

Date and location of any existing Last Will and Testaments:

Date and location of any existing Codicils:

Date and location of any existing Health Care Directives:

Date and location of any existing Power of Attorneys:

Name of Personal Representative:

Name of Co-Personal Representative:

If minor children exist, Name of Guardian and any Co-Guardian:

If minor children exist, Name of Trustee and any Co-Trustee:

If Trust is created for minor children, list at what ages you would like distributions to be made:

Life Insurance Policies

Name of Company held by:

Beneficiary:
yes / no

Real Estate Information

Ownership

Value

Stocks, Bonds, Annuities, other Assets

Name of Institution held by:

Value

Checking, Savings, Money Market Accounts

(List institution where held, value and ownership)

Household Good, Automobiles, Jewelry, Boats, Loans to Relatives, etc.

Specific requests:

 


The information you obtain at this site is not, nor is it intended to be, legal advice. You should consult an attorney for individual advice regarding your own situation.

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