Estate Planning Information Packet

Please try to have this Information Packet completed at least one business days prior to our initial meeting (this will ensure we have enough time to understand the specifics of your situation before our meeting).

If you need assistance completing the information, call our office at (818-334-2805) and we will help you.

DON’T WORRY ABOUT TOTAL ACCURACY – JUST DO THE BEST YOU CAN

Step 1 of 6 - Personal Information

Personal Information
Legal Name(Required)
Prefix First Middle Last Suffix
name most often used to title property and accounts
Also Known As

other names used to title property and accounts
Prefer to be called(Required)
Birth date(Required)
Month
Day
Year
Social Security #
US Citizen?(Required)
- Yes
- No
Home Address(Required)
Street Address Address Line 2 City State ZIP Code
County of Residence(Required)
Home Telephone(Required)
Business Telephone
Employer
Position
Business Address
Street Address Address Line 2 City State ZIP Code
E-mail Address(Required)
Is it okay to communicate with you via your E-mail address?(Required)
- Yes
- No
Marital Status(Required)
- Married
- Divorced
- Widowed
- Single
Date of Marriage(Required)
Month
Day
Year
Children and/or Other Family Members
Click the plus button to add additional rows.
Name Birth date Parent or Relationship

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Advisors
Personal Attorney
First Last
Personal Attorney Phone
Accountant
First Last
Accountant Phone
Financial Advisor
First Last
Financial Advisor Phone
Life Insurance Agent
First Last
Life Insurance Agent Phone

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Property Information

This Property Information section is designed to help you list all the property you own and what it is worth. If you do not own property under a particular heading, just leave that section blank.

How you own your property is extremely important for purposes of properly designing and implementing your estate plan. For each property please indicate how the property is titled. When doing so, please use the following abbreviations:

Owner of Property	Use
Your name alone, with no other person	S
Joint Tenancy with someone other than a spouse, i.e. a child, parent, etc	JTO
If you cannot determine how the property is owned	?

REAL PROPERTY
TYPE: Any interest in real estate including your family residence, vacation home, time share, vacant land, etc.
General Description and/or Address Owner Market Value Loan Balance
Total Market Value of Real Property
Total Loan Balance of Real Property
INCOME
Earned Monthly Income from Labor:
Monthly Social Security Income:
Monthly Pension Income:
Other Monthly Income:
Total Income
FURNITURE AND PERSONAL EFFECTS

TYPE: List separately only major personal effects such as, jewelry, collections, antiques, furs, and all other valuable non-business personal property (indicate type below and give a lump sum value for miscellaneous, less valuable items.)
Miscellaneous Furniture and Household Effects (Total)
MAJOR PERSONAL EFFECTS
List any major personal effects such as jewelry, collections, antiques, furs and all other valuable non-business personal property.
Type or Description Owner Market Value
Total Furniture and Personal Effects
AUTOMOBILES, BOATS AND RVS
TYPE: For each motor vehicle, boat, RV, etc. please list the following: description, how titled, market value and encumbrance:
BANK & SAVINGS ACCOUNTS
TYPE: Checking Account "CA", Savings Account "SA", Certificates of Deposit "CD", Money Market "MM" (indicate type below). Do not include IRA's or 401(k)'s here

Note: If Account is in your name (or your spouse’s name) for the benefit of a minor, please specify and give minor’s name.
Name of Institution and account number Type Owner Amount
Total Bank & Savings Accounts
STOCKS AND BONDS
TYPE: List any and all stocks and bonds you own. If held in a brokerage account, lump them together under each account. (indicate type below)
Stocks, Bonds or Investment Accounts Type Acct. Number Owner Amount
Total Stocks and Bonds
LIFE INSURANCE POLICES AND ANNUITIES
TYPE: Term, whole life, split dollar, group life, annuity. ADDITIONAL INFORMATION: Insurance company, type, face amount (death benefit), whose life is insured, who owns the policy, the current beneficiaries, who pays the premium, and who is the life insurance agent.
Total Life Insurance Policies and Annuities
RETIREMENT PLANS
TYPE: Pension (P), Profit Sharing (PS), H.R. 10, IRA, SEP, 401(K). ADDITIONAL INFORMATION: Describe the type of plan, the plan name, the current value of the plan, and any other pertinent information.
Total Retirement Plans
BUSINESS INTERESTS
TYPE: General and Limited Partnerships, Sole Proprietorships, privately owned corporations, professional corporations, oil interests, farm and ranch interests. ADDITIONAL INFORMATION: Give a description of the interests, who has the interest, your ownership in the interests, and the estimated value of the interests.
Total Business Interests
MONEY OWED TO YOU
TYPE: Mortgages or promissory notes payable to you, or other moneys owed to you.
Name of Debtor Date of Note Maturity Date Owed to Current Balance
Total Balance Owed to You
ANTICIPATED INHERITANCE, GIFT, OR LAWSUIT JUDGMENT
TYPE: Gifts or inheritances that you expect to receive at some time in the future; or moneys that you anticipate receiving through a judgment in a lawsuit. Describe in appropriate detail.
Total Estimated Value of Gifts or Inheritance
OTHER ASSETS
TYPE: Other property is any property that you have that does not fit into any listed category.
Type Owner Value
Total Value of Other Assets
SUMMARY OF VALUES
Enter the total value for each asset
Real Property
Furniture and Personal Effects
Automobiles, Boats and RV’s
Bank and Savings Accounts
Stocks and Bonds
Life Insurance and Annuities
Retirement Plans
Business Interests
Money owed to you
Anticipated Inheritance, Etc.
Other Assets
Total Assets

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	High concern	Some concern	Low concern	N/A
Desire to get affairs in order and create a comprehensive plan to manage affairs in case of death or disability.
Providing for and protecting a spouse.
Providing for and protecting children.
Providing for and protecting grandchildren.
Disinheriting a family member
Providing for charities at the time of death.
Plan for the transfer and survival of a family business.
Avoiding or reducing your estate taxes.
Avoiding probate.
Reduce administration costs at time of your death
Avoiding a conservatorship (“living probate”) in case of a disability.
Avoiding will contests or other disputes upon death.
Protecting assets from lawsuits or creditors.
Preserving the privacy of affairs in case of disability or at time of death from business competitors, predators, dishonest persons and curiosity seekers.
Plan for a child with disabilities or special needs, such as medical or learning disabilities.
Protecting children’s inheritance from the possibility of failed marriages.
Protect children’s inheritance in the event of a surviving spouse’s remarriage.
Provide that your death shall not be unnecessarily prolonged by artificial means or measures.
Avoid or limit MediCal claims on your assets should you require long-term care.
Ensure that your family has enough life insurance to provide a comfortable lifestyle no matter what.
For parents only: protect your children from relatives who would be poor, abusive or even dangerous guardians or from foster care.
For business owners only: protect your children by providing for the orderly continuation and transfer of family business interests rather than a distress sale.
For parents only: protect your children from acquaintances and relatives who should not be allowed to be alone with your children.
Ensure that a special needs beneficiary has assets that are protected from government seizure while retaining eligibility for needed services.

Law Offices of Lisa S. Golshani

Estate Planning Information Packet

Step 1 of 6 - Personal Information

Personal Information

Advisors

Important Family Questions

Property Information

SUMMARY OF VALUES

DESIGN INFORMATION

Name	Birth date	Parent or Relationship

General Description and/or Address	Owner	Market Value	Loan Balance

Type or Description	Owner	Market Value

Name of Institution and account number	Type	Owner	Amount