Estate Planning Worksheet - Tennessee Baptist Foundation

Full Name(s)

Date of Birth

Phone(Home)

Phone(Work)

Address

County of Residence

Date of Marriage

Occupation(Husband)

Husband - US Citizen

Wife - US Citizen

Have you ever filled a gift tax return (Federal or Slate)

Do you currently have a will or trust

Yes No

If married, do you have a prenuptial agreement?

Yes No

Describe your health and life expectancy

Please indicate

Do you plan to have more children?

Age

Adopted Children

Total No. of Grandchildren

Age Range of Grandchildren

0-2 2-6 6-12 12-18

Are your children and grandchildren in good health?

Yes No

Do any of your children have tacable estates? (Over $5,000,000)?

Yes No

Are you currently supporting anyone other than your spouse and you?

Yes No

If not, whom?

After Death of both you and your spouse

1st Guardian 2nd Guardian

Personal Representative

Yes No

(Please name alternates below if your spouse cannot serve.)

Retirement Plans (Including IRAs): Total Value $

Cash/Checking Accounts/Savings Accounts/Money Market Accounts/Investment Accounts:

LIFE Insurance and Annuity Policies: Total Value: $

In the event of the simultaneous death of you, your spouse, and your children:

(A) % or $ to (charitable bequest) (B) % or $ to (charitable bequest) (C) % or $ to (charitable bequest) (D) % to B per stirpes LJ per capita (E) % to per stirpes U per capita (F) % to 0 per stirpes Q per capita (G) % to Q per stirpes D per capita

Is your individual gross estate valued at over $12,060,000, or $24,1200,000 jointly?

If you are married, is your real property titled as Joint Tenants with Right of Survivorship? (Please provide a copy of your Warranty Deed so we may review this with you.)

Do you own real estate in any state other than your state of residence?

Yes No

Do you have an ownership interest in a business? If YES, please attach description or evidence of interest).

Yes No

Do you have any existing Will(s) or Trust Agreements? (If YES, please provide a copy of each document so that we may properly coordinate with, amend, or replace your existing plan.)

The executor, trustee, and guardian have extensive duties, the most important of which will be noted. Although it may be an honor to be named, it also involves significant work for which the person or entity named is entitled to compensation. In selecting a person or entity to serve, give thought to the position's duties and responsibilities, the person's experience and ability, and the time that will be involved to properly execute the assigned duties.

A. EXECUTOR

My initial executor is __ my surviving spouse ___ other: ___________ (Husband)

My successor executor(s) is the following: ___________________

EXECUTOR. My initial executor is __ my surviving spouse ___ other: ___________ (Wife)

My successor executor(s) is the following: ___________________

Note: The Executor must do the following:

Identify, collect and value each asset and debt of the decedent;
Invest the assets to produce income and growth;
Verify each claimed debt before paying the debt;
Mediate disputes among beneficiaries over disputed items;
Divide and distribute all personal property among persons designated;
Prepare and file US and State income, gift and death tax returns and arrange to have money to pay any taxes due. Death tax returns are due nine (9) months from the date of death.

B. GUARDIAN

If you have minor children, whom would you want to have serve as their guardians (guardian of the person, not their money) if your spouse and/or you are deceased?

Second choice: ________________ Only if still married? _______

Note: The person or persons to be appointed as guardian are persons who will raise your child or children in the manner you would want them raised. Since the money for your child or children can be put in trust, the guardians of the person of the child or children do not necessarily have to be a good money manager. If you name a couple, please indicate if you are comfortable with only one of them serving if only one of them can serve. Before naming anyone, it is recommended that you speak to the person whom you are considering to ensure that the person is willing to serve.

C. POWER OF ATTORNEY FOR FINANCIAL MATTERS

Husband: In the event that you become incapacitated during your lifetime, whom would you want to manage your financial affairs? Surviving spouse is first choice. List other choices in order of priority: _________________________

Wife: In the event that you become incapacitated during your lifetime, whom would you want to manage your financial affairs? Surviving spouse is first choice. List other choices in order of priority: _________________________

D. POWER OF ATTORNEY FOR HEALTHCARE

Husband: In the event that you become incapacitated during your lifetime, whom would you want to make health care decisions for you? Surviving spouse is first choice. List other choices in order of priority: _________________________

Wife: In the event that you become incapacitated during your lifetime, whom would you want to make health care decisions for you? Surviving spouse is first choice. List other choices in order of priority: _________________________

Would you like to execute an Advance Care Plan (provides guidance on the type and scope of medical treatment you may or may not want)? Y/N

Yes No

IV. ESTATE PLAN

Specific Distributions: Is there any specific property (furniture, family heirloom, bank account) or specific dollar amount that you wish to leave to a particular person before making any other distributions from your estate? If so, please list property and person: (if additional space is needed, please write on the back of this sheet)

Yes No

Other Distributions: Household goods to: spouse __ _

To my spouse first, if he/she survives me surviving children __ _

If a beneficiary predeceases you, what would you like to have happen to the property? other __ _

To beneficiary's children ___ Divided equally among surviving beneficiaries __

Do you wish to make any bequests to a charity or your church? If so, describe what you would like to bequest: ______________________________________

Ultimate beneficiaries: If all beneficiaries and descendants listed above predecease you:

To my heirs (including remote relatives) only __

50% to heirs on each spouse's side of family __

Other (please specify) _________

KEY QUESTIONS

Is there anyone you would like to inherit from your estate who is financially irresponsible or has a disability that would make it difficult for them to manage their inheritance? _______________________

Is there anyone you would like to inherit from your estate currently receiving disability or other governmental benefits? __________________

Trustee: Whom do you wish to manage any trusts created in your will?

Surviving spouse is first choice:

List other choices in order of priority: ______________________

What is your annual household income? (H) _____ (W) _____ _

What is the source of your income (i.e., salary, retirement, passive, etc.)? Y__N__.

If so, describe anticipated change: ___________

Do you view your assets as: O equally owned by both spouses O separate property

If a Revocable Living Trust is requested, please also provide the following:

(1) a copy of the recorded Warranty Deed and tax identification number for all Real Estate in which you have a personal ownership interest, including your residence and any timeshare interest(s) you own (the latest tax bill(s) will have the ID number for each property if it is not published on the recorded deed)
(2) evidence of any promissory notes or recorded mortgages payable to you
(3) evidence of interest(s) you have in any business or partnership.

Please attach additional sheets as necessary to provide all the information requested.

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