SIMPLE WILL QUESTIONNAIRE                RETURN HOME PAGE
1.
Name
____________________________________________________________
2.
Address:
____________________________________________________________
____________________________________________________________
Telephone # _________________________
3.
Spouse’s Name (If married): ________________________________________________
4.
A specific bequest is a gift of a specific item or asset to a named person or entity.   
Do you want some specific bequests in your simple will? ___________
(If you answered YES, please list the specific item(s), the person you want to receive them,
and their relationship to you on a separate
sheet of paper and attach it to this questionnaire.)
5.
In addition to any specific bequest request above, how would you like your personal
property to be distributed? (Personal property would include items such as jewelry, furniture,
cars, and other personal items.)_____________________________________________________
______________________________________________________________________________
______________________________________________________________________________
6.
Your residuary estate includes any and all property not specifically gifted. Who is the
first choice to receive your residuary estate and what is their relationship to you?_____________
______________________________________________________________________________
7.
If your first choice does not survive you, who will the residuary estate be distributed to
and what is their relationship to you?________________________________________________
______________________________________________________________________________
8.
Who will serve in that capacity of executor? Usually the spouse. (Name and address)_____________________________
______________________________________________________________________________
______________________________________________________________________________
9.
Will the executor serve with or without bond? (The purpose of the bond is to protect the
estate if the executor misappropriates the estate assets. A bond is often not necessary and can be
very expensive, therefore, you may wish not to require one.)_____________________________
10.
Who will serve as an alternate executor in the event that the
executor does not or cannot serve for any reason? (Name and address)
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
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12.
Please list all children. (Name, address and age)
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
13.
If you have minor children who would you like to serve as trustee in your will?
______________________________________________________________________________
14.
Do you wish to nominate a guardian only if your spouse does not survive you?
______________________________________________________________________________
15.
Do you wish to nominate a sole guardian or co-guardians? ________________________
16.
Enter the guardian(s) names(s) and address(es).
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
17.
Who will serve as an alternate guardian in the event that the guardian named does not
serve for any reason? (Name and Address)___________________________________________
______________________________________________________________________________
______________________________________________________________________________
18.
Please list all of your major assets. ________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
19.
Please list all of your liabilities. (Including all debts, unpaid mortgages, or other loans)
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
20.
Do you have an existing will? Who has the original?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
21.
Would you like to discuss creating a Power of  Attorney, a Living Will and a Health Care Proxy?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
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