SIMPLE WILL QUESTIONNAIRE Home  Print This 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) ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ 11. Please list all children. (Name, address and age) ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ 12. If you have minor children who would you like to serve as trustee in your will? ______________________________________________________________________________ 13. Do you wish to nominate a guardian only if your spouse does not survive you? ______________________________________________________________________________ 14. Do you wish to nominate a sole guardian or co-guardians? ____________________________ 15. Enter the guardian(s) names(s) and address(es). ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ 16. Who will serve as an alternate guardian in the event that the guardian named does not serve for any reason? (Name and Address) ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ 17. Please list all of your major assets. ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ 18. Please list all of your liabilities. (Including all debts, unpaid mortgages, or other loans) ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ 19. Do you have an existing will? Who has the original? ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ 20. Would you like to discuss creating a Power of  Attorney, a Living Will and a Health Care Proxy? ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________