COMPLETION SERVICES QUESTIONNAIRE
Please Complete All Applicable
Sections
Select Your County:
Select
a county in Mississippi Adams County Alcorn
County Amite County Attala
County Benton County Bolivar
County Calhoun County Carroll
County Chickasaw County Choctaw
County Claiborne County Clarke
County Clay County Coahoma
County Copiah County Covington
County DeSoto County Forrest
County Franklin County George
County Greene County Grenada
County Hancock County Harrison
County Hinds County Holmes
County Humphreys County Issaquena
County Itawamba County Jackson
County Jasper County Jefferson
County Jefferson Davis County Jones
County Kemper County Lafayette
County Lamar County Lauderdale
County Lawrence County Leake
County Lee County Leflore
County Lincoln County Lowndes
County Madison County Marion
County Marshall County Monroe
County Montgomery County Neshoba
County Newton County Noxubee
County Oktibbeha County Panola
County Pearl River County Perry
County Pike County Pontotoc
County Prentiss County Quitman
County Rankin County Scott
County Sharkey County Simpson
County Smith County Stone
County Sunflower County Tallahatchie
County Tate County Tippah
County Tishomingo County Tunica
County Union County Walthall
County Warren County Washington
County Wayne County Webster
County Wilkinson County Winston
County Yalobusha County Yazoo
County
Your Name:
Address:
City:
State:
Zip:
Phone:
Fax:
Your E-Mail:
Date of
Birth:
U.S. Citizen? Yes
No
Other Names:
Gender:
Male
Female
Name of Spouse:
v
Children and Date of Birth
Child One:
Child Two:
Child Three:
Child Four:
m
Specific Property
Complete this section only if you have
specific property be left to a specific person. i.e. A diamond ring to
my sister.
Person to Receive:
Property:
Person to Receive:
Property:
Person to Receive:
Property:
Person to Receive:
Property:
k
Executor - Personal Representative
Executor:
This is the person who will be in
charge of your estate and will probate your will, pay your bills and distribute
your estate based in your wishes. This will be your Spouse unless you name
someone else.
Alternate
Executor:
This person will be in charge of
your estate if the first person you named cannot serve.
h
Trustee and Guardian
Trustee
for minor Children:
Your trustee will be in charge of
the estate you leave to your minor children. This will establishes
a trust for your minor children. If a trust were not established by you
for minor children then the court would name the person to handle the portion
of your estate you leave to minor children.
Alternate Trustee:
Guardian
for minor Children:
Your guardian will be in charge
of your children if a guardian is needed.
Age Trustee
to terminate trust:
The trust is established to provide
that your trustee will manage your estate and make distributions to your
children based upon their needs until the children reach a certain age.
This blank is for the age of your children at which your trustee will distribute
the assets of the trust to your children outright. i.e. 21, 24, etc.
You decide the age at which you feel your children should be given your
estate.
n
Property and Persons to Receive
General
Statement:
Except for the specific property
provisions above, this Will leaves everything to your Spouse, or if you
spouse predeceases you, to your children. If you would like to specify
something different, please provide it here. Example: I do not want to
leave any property to a certain child, or I only want to leave x to a certain
child.
k
Form Delivery Instructions
In what format would you desire
your completed Form?
Microsoft
WordAdobe Acrobat Regular Mail
h
Optional Items
Name of
Cemetery:
County:
State:
Names of
Witnesses:
Witness One:
Witness Two:
If you know who will witness your
will, provide their names. If you do not know, leave this section blank.
Witnesses should not be related to you or a person you have named in your
will to receive any portion of your estate.
Describe Other Provisions desired
in Will, if any: