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Estate Planning, Probate & Family Law | San Jose, CA
info@delponteandhirz.com
(408) 294-4525
Estate Planning, Probate & Family Law | San Jose, CA
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Family Law
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info@delponteandhirz.com
(408) 294-4525
Estate Planning Client Form
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Client Information
Full Name
*
First
Last
Address
*
Street Address
Address Line 2
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Armed Forces Americas
Armed Forces Europe
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ZIP Code
Date of Birth
*
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SSN (Optional)
Day Phone
Evening Phone
Email
*
Enter Email
Confirm Email
County of Residence
*
Employer
Retirement Date
Month
Day
Year
Veteran
Yes
No
Spouse Information
Are you married or in a registered domestic partnership?
*
Yes
No
Full Name
*
First
Last
Address
*
Street Address
Address Line 2
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Date of Birth
*
Month
1
2
3
4
5
6
7
8
9
10
11
12
Day
1
2
3
4
5
6
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10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Year
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
SSN (Optional)
Day Phone
Evening Phone
Email
*
Enter Email
Confirm Email
County of Residence
*
Employer
Retirement Date
Month
Day
Year
Veteran
Yes
No
Family Information
Do you have any children?
*
Yes
No
Children
Full Name
DOB
Do you have any grandchildren?
*
Yes
No
Granchildren
Full Name
DOB
Have you or your spouse been married before?
Yes
No
Do you have children from a prior marriage or relationship?
Yes
No
Prior Marriage/Relationship Children
Full Name
DOB
Do you or your spouse have any children who have died leaving children (your grandchildren)?
Yes
No
Names of orphaned grandchildren
Full Name
DOB
Does anyone to whom you may be leaving part of your estate require any help or protection in managing money or other property?
Yes
No
Do you and your spouse have a pre-nuptial agreement?
Yes
No
Financial Information
Income Producing Assets: Bank accounts, Brokerage accounts, Stocks, Corporate or U.S. Bonds, other. Do not include Pensions, 401(k)s, IRAs or other retirement accounts
Incoming Producing Assets
Financial Institution
Acct #
Name on account
Have you or your spouse made any transfers or gifts in excess of $10,000 or more during the past three years?
Yes
No
Real Estate and Business
Real Estate and Business:
Physical Address of Property
Purchase Date
Name on Property
Do you or your spouse have any interest in any business?
Yes
No
Describe
Life Insurance
Do you have life insurance?
Yes
No
Life Insurance:
Whose Life?
Company
Beneficiary
Policy No.
Other Property with Designated Beneficiaries
Do you have IRAs, Vested Pension Plans, Annuities, or other assets that would pass on your death to a particular designated beneficiary?
Other Property with Designated Beneficiaries
Description
Designated Beneficiary
Do you or your spouse expect an inheritance?
Yes
No
Are you or your spouse the beneficiary of any trust?
Yes
No
Personal Property
Autos, Recreational Vehicles, Boats, Antiques, Heirlooms, Jewelry, Collections, etc.
Personal Property
Description of Property
In Whose Name?
Legal Documents
Do you have a Last Will and Testament
Yes
No
Date Executed
Location of Document
Do you have a Durable Power of Attorney?
Yes
No
Date Executed
Location of Document
Do you have an Advance Healthcare Directive?
Yes
No
Date Executed
Location of Document
Do you have a Living Trust?
Yes
No
Date Executed
Location of Document
Finishing Up
Choice of Successor Trustees:
*
Enter up to 3 names
Choice of Healthcare Agent(s)
*
Name
Address
Phone
Enter up to 3 names
Proposed Distribution of Assets:
Please bring copies of the following documents with you to your meeting with the attorney:
Will, Codicil, Trust Agreements
Living Will, Health Care Declaration, or Power of Attorney, Durable Powers of Attorney
A List of full names, addresses, and telephone numbers of people who have a part in your planning as executors, trustees, beneficiaries of your estate, helpers, and advisors
Retirement plans, including any forms designating beneficiaries
Comments
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