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Karen Telschow Johnson
Nicole Smith
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Rebecca Thomas
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Martha Zarr
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Home
Practice Areas
Estate Planning
Elder Law
Last Will & Testament
Trusts
Powers of Attorney
Probate
Guardianship
Medicaid Planning
Disability Planning
About Us
In the Community
Karen Telschow Johnson
Nicole Smith
Bob Telschow
Rebecca Thomas
Monika Worsley
Martha Zarr
Contact
2025 Estate Planning Packet – Individual
2025 Estate Planning Packet – Individual
Estate Planning Information Packet
Thank you for contacting us about estate planning. This fact sheet can be helpful in organizing your thoughts on estate planning and to provide us with information about your family and wealth. Completing it and returning it to us before your consultation is very helpful to us. If your time is limited, or you find it overwhelming, know that you can fill out the simple “Personal Information” section and we can discuss the rest with you during our initial consultation.
Personal Information
Full Legal Name
Nickname or preferred name
Date of birth
MM slash DD slash YYYY
Last 4 digits of the SSN
Occupation
Best Phone Number
Email address
Home Address (include County)
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Ã…land Islands
Country
Name and phone number of your broker or financial planner (if applicable):
Who can we thank for referring you to our law firm?
Are you married? Yes or no
If you are previously married, please list the name of the previous spouse
how the relationship ended (e.g., divorce or death), approximate dates of marriage, and whether there were any children from previous marriages/relationships.
Children
Child
Full legal name (include address/phone number only if the children are of legal age)
Living
Yes
No
Age
Sex
Marital status
Any children of their own?
Yes
No
Issues to discuss? Yes or No
Yes
No
ASSETS/LIABILITIES
(Indicate Yes or No for each)
Safe deposit box (indicate the name of the bank)
Bank
Yes/No
Yes
No
Bank accounts (not IRAs or retirement plans)
Yes
No
Stocks, Bonds, and Mutual Funds (not IRAs or Retirement Plans
Yes
No
Closed companies, partnerships, limited liability companies, etc
Yes
No
Real Estate in Texas
Yes
No
Real Estate Outside Texas
Yes
No
Automobiles, boats, etc.
Yes
No
Life Insurance and Life Annuities
Yes
No
IRAs, 401k(s), other retirement plans
Yes
No
Other Assets/Liabilities, including Cryptocurrencies
Yes
No
DEVICE PLAN
(Describe in general terms how you want to leave your property upon death)
Untitled
(Example: To my children alike, etc. Just a general idea of how you would like things to happen and we can discuss it further in your consultation).
Age of Contingent Trust
At what age(s) would you like your beneficiary to inherit? (The law says 18, but you can choose a higher age when you feel a beneficiary may be ready to better handle finance)
Age
Please enter a number from
18
to
100
.
Any specific gifts?
FINAL REMAINS
Do you prefer burial or cremation? If you have made any pre-need arrangements for your last remains, such as purchasing a burial plot, a headstone, or making cremation arrangements in advance, please note that here.
FIDUCIARIES
(Persons to whom you grant legal authority to act on your behalf)
EXECUTOR OF THE WILL
(The executor is the person who will probate your will in court if necessary.)
Executor
First Alternate
Second Alternate
TESTAMENTARY TRUST TRUSTEE
(This is a trust created by a will for a beneficiary who is incapacitated or who has not reached the age of 18 (or the age that you selected above).
Trustee of the Testamentary Trust
First Alternate
Second Alternate
MEDICAL POWER OF ATTORNEY
(The health care agent is the person who will make decisions for you if you become incapacitated).
Health Care Agent
First Alternate
Second Alternate
DURABLE POWER OF ATTORNEY
(This document extends your rights in all things finances to the agents you select. During our meeting, we can talk about the pros and cons of this document being effective immediately rather than being effective for disability)
Financial Agent
First Alternate
Second Alternate
GUARDIAN OF THE PERSON
(If a court ever needs to place a guardian over your physical person because of an incapacity, who would you want to serve as the guardian of your person?)
Guardian of the person
First Alternate
Second Alternate
Exclusions of guardians (if any)
GUARDIAN OF THE ESTATE
(If a court ever needs to place a guardian over your finances because of an incapacity, who would you want to serve as the guardian of your estate?)
Guardian of the Estate
First Alternate
Second Alternate
Exclusions of guardians (if any)
GUARDIAN OF YOUR MINOR CHILDREN
(The guardian is the person who will physically care for minor children in the event that both parents die.)
Guardian(s) of your minor children
First alternate(s)
Second Alternate Guardian(s)
HEALTH CARE AGENT FOR YOUR MINOR CHILDREN
(The health care agent is the person who will make medical decisions for your minor children in the event that both parents are unable to make those decisions.)
Health Care Agent for Your Children
First Alternate
Second Alternate
REVOCABLE TRUST
[If a trust-based estate plan is selected, this section will apply. We will discuss this in his consultation, but it is good to think about who you would like to serve as alternate Trustees if necessary.]
Initial Trustee
You would be both the Grantor and the Initial Trustee; After becoming incapacitated or passing away, you would need the alternate trustee(s).
First Alternate
Second Alternate