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Simply complete this questionnaire
and submit it. Please complete all applicable sections.
Will QUESTIONNAIRE
Your County:
Your Name:
Address:
City:
State:
Zip:
Home Phone:
Fax:
E-mail:
Date of
Birth:
U.S. Citizen? Yes
No
Other Names:
Your E-Mail:
Gender:
Male Female
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.
n
Property and Persons to Receive
General
Statement:
Except for the specific property
provisions above, this Will leaves everything to your Spouse, or if your
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
Format
of Form?
h
Optional Items (All remaining
Items are Optional)
Name of
Cemetery:
County:
State:
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.
Other Provisions desired in Will:
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