Estate Planning & Elder Law Questionnaire

This Questionnaire gathers information that is necessary for our analysis of your estate planning and elder law needs.

Personal Information
Full Name*
First Middle Last Suffix
Preferred Name
Preferred
If you prefer to be called something other than your full name, please list it here
Gender*
Date of Birth*
MM slash DD slash YYYY
Address*
Street Address Address Line 2 City State ZIP Code
Mobile Number*
Email*
Employer
Employer
Do you have children?*
If you have children, you can tell us about them on the next page.
Marital Status*
If you are married after a previous spouse's death, select Married.
Anniversary*
MM slash DD slash YYYY
Does your spouse have children?*
If your spouse has children, you can tell us about them on the next page.
Are your children and your spouse's children the same?*
You can tell us about the children on an upcoming page.
Spouse's Personal Information
Please tell us about your spouse.
Spouse Name*
First Middle Last Suffix
Please complete this even if your spouse is deceased
Spouse's Preferred Name
Preferred
If your spouse prefers to be called something other than their full name, please list it here
Spouse's Gender*
Spouse Date of Birth*
MM slash DD slash YYYY

If you are married after your previous spouse's death, list the information for your current spouse.
Spouse's Address
Same As Previous Address

Street Address Address Line 2 City State ZIP Code
Spouse's Mobile Number*
Spouse's Employer
Spouse's Profession/Field/Employment
Family (Children) Information
It helps us when we understand your family structure. This section allows you to tell us about your children and their family.
How many children in the family?*
Please tell us the number of children in your/your spouse's family. For each child, whether your child, your spouse's child, or a child of both, we've created spots where you can tell us about them. Their information is important to the planning we do.
Child 1: Full Name*
First Middle Last Suffix
Preferred Name
Preferred
Child 1: Date of Birth*
MM slash DD slash YYYY
Whose Child?*
Does Child 1 Live With You?*
Child 1: Address
Street Address Address Line 2 City State ZIP Code
Child 2: Full Name*
First Middle Last Suffix
Child 2: Preferred Name
Preferred
Child 2: Date of Birth*
MM slash DD slash YYYY
Whose Child?*
Does Child 2 Live With You?*
Child 2: Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Family (Children) Information: Continued
Child 3: Full Name*
First Middle Last Suffix
Child 3: Preferred Name
Preferred
Child 3: Date of Birth*
MM slash DD slash YYYY
Whose Child?*
Does Child 3 Live With You?*
Child 3: Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
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Estate Planning & Elder Law Questionnaire

Estate Planning & Elder Law Questionnaire

Personal Information

Spouse's Personal Information

Family (Children) Information

Family (Children) Information: Continued

K.T. Williams Law PLLC

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