Last Will and Testament Intake

Name *

First

Last

Address

Address Line 1

Address Line 2

City

State

Zip Code

Are you married? *

Spouse Name *

First

Last

Do you have children(biological or adopted)? *

Name of Child(ren)

List each child’s name and their date of birth.

Name of 1st Executor

Executor if the 1st Executor is unable or unwilling to serve as executor.

Do you own real estate *

REAL ESTATE: Name of beneficiary and the property address. *

specify name of beneficiary, property address, amount or percentage.

PERSONAL PROPERTY: Name of beneficiary and the personal property. *

Specify name of beneficiary, specify items, amount or percentage.

RESIDUARY CLAUSE: Name of beneficiaries and percentages for any remaining property not already specified… *

Specify name of beneficiary and the % percentage to bequest.

Special Directives *

Enter any special directives and/or bequests of your last wishes. (Specify).

DISCLAIMER/RELEASE OF LIABILITY

I understand that my last will and testament is being prepared by a non-attorney, volunteer of a 501c3 non-profit organization. I understand that the services provided is limited to document preparation services and does not imply, services rendered by a law firm. I understand and certify no legal services or legal advice is or can be provided in relation to your preparation of the last will and testament document. I understand the preparer is a volunteer, not an attorney or a law firm. I understand services provide does not substitute for an attorney or law firm. No kind of advice, explanation, opinion, or recommendation about possible legal rights, remedies, defenses, options, selection of legal forms or strategies were provided. I understand, If I require these types of services I must consult an attorney. Completing and signing this intake form me and beneficiaries releases the non-profit organization and its volunteers from any potential or future liabilities in relation to the preparation of my last will and testament.

Signature