Kenneth Vercammen & Associates, P.C.
2053 Woodbridge Ave.
Edison, NJ 08817
(732) 572-0500
www.njlaws.com

Friday, June 3, 2016

Probate/ Inheritance/ Estate Administration

Probate/ Inheritance/ Estate Administration
         Please fill out completely and fax or mail back. This form is extremely important. Your accuracy and completeness in responding will help me best represent you. All sections and information must be filled out prior to sitting down with the attorney.

PLEASE PRINT

YOUR NAME _____________________________________________

ADDRESS _______________________________________________

CITY ______________________ STATE ____    ZIP _____________

CELL (____)_____________________________________________

PHONE-DAY(____)_______________ NIGHT (____)______________

Email   _______________________________________________

Decedent’s Name    _______________________________________

Date of Death (mm/dd/yy) ___ ___ /___ ___ /___ ___ ___ ___  

Referred By:     __________________________________________
       If referred by a person, is this a client or attorney?  If you heard about the law office on the Internet, which search engine?  What search terms did you use?

Your relation to the person who passed away: __________________

Date of Will? (mm/dd/yy) ___ ___ /___ ___ /___ ___ ___ ___
(If no will, write no will)

Location of original Will __________________________________


Executor/ Administrator if not person filing out this form: ___________

TODAY'S DATE ____/_____/__________      
              Probate Q-Inherit  Quest       rev 1/15/15

*All Pages and Information must be filled out prior to seeing the Attorney.  This information is required by the Surrogate's Office and the Inheritance Tax Bureau.
                                                                                  
Indicate if Surrogate Probate letters were issued and which county issued:

________________________________________________


County of Residence     ________________________________

Decedent’s S.S. No.     ___ ___ ___ /___ ___ /___ ___ ___ ___

       *The following questions are required by the Surrogate's Office and the Inheritance Tax Bureau to be answered.  Please answer all these questions to the best of your knowledge so we can best help you. If none, write none.

SCHEDULE “A” REAL PROPERTY  If none, write none



1. Street and Number _____________________________________



Town: ____________________

Lot: ___ Block:  ____ County: ____________________



Title/Owner of Record: _______________


Tax Assessor Assessed Value: $____________________




Full Market Value of Property:  $____________________ 

Mortgage Balance: $______________________ [if none write none]



Any other Real Estate: $______________________





ASSETS
         All Other Personal Property Owned Individually or Jointly; Market Value, Indicate the Manner of Registration at Date of Death.
         If none, write none for each line
SCHEDULE B (1) - BANK ACCOUNTS/BROKERAGE ACCOUNTS
RESIDENT DECEDENT Bank Account –
Name of Bank, Acct. # _____________                            $_________

___________________________________________   $_________
___________________________________________    $_________
Stock - Name of Stock Co., Acct. # ________________  $_________
___________________________________________   $_________
Cars _______________________________________   $_________
Other assets over $10,000 ______________________  $_________
MUNICIPAL & CORPORATE BONDS [ if none write none ______
___________________________________________  $_________
___________________________________________  $_________
___________________________________________  $_________
___________________________________________  $_________
___________________________________________  $_________

SCHEDULE B  Closely held Businesses? Yes  _____  No ______
SCHEDULE C  Gifts/Transfers of more than  $13,000 within 3 years prior to death? Yes  _____  No ______

SCHEDULE “D” EXPENSES
Estimated Expenses for Funeral  $ ____________________

Paid Estate Administration Expenses   $ ____________________


Other Administration Expenses   (list individually), attach receipts.
Major debts of estate, inc credit card
 Expense _________________ $ ____________________
 Expense _________________ $ ____________________
 Expense _________________ $ ____________________
 Expense _________________ $ ____________________
 Expense _________________ $ ____________________

         BENEFICIARIES AND ADDRESSES
(State full names and addresses of all who have an interest, vested, contingent or otherwise, in estate)

HEIRS AT LAW/
NEXT OF KIN:  RELATIONSHIP:   ADDRESS:   APPROX. AGE:    % INTEREST:                                     

______________________________________________________

______________________________________________________

______________________________________________________

______________________________________________________

______________________________________________________

       In case of Intestacy [no Will], the parentage of all collateral heirs (such as nieces, nephews, cousins, etc.) must be set forth. The relationship of stepparent, stepchild, stepbrother or stepsister must be so stated.

Any specific bequests/gifts in Will? _________________________

______________________________________________________

(NOTE: LIST CHILDREN OF DECEASED NEXT OF KIN - /ALSO GIVE AGE OF ANY MINORS)
State full names of all beneficiaries who died before or after decedent's death:

______________________________________________________

________________________________________________


SUMMARY
1. Real Property - Schedule A                            $_______________
2. All Other Assets    - Schedule B(1)                $_______________
  Gross Estate . . Total Lines 1 thru 4     $_______________
  Deductions/Expenses . . . - Schedule D   $_______________

Is the decedent’s taxable estate plus adjusted taxable gifts exceed $675,000?       Yes __ No ___ If yes, by how much $ _______
Have or will you file a NJ Estate Tax Return for estates over $675,000.?      __________________
Any gifts within the past 5 years over $10,000 _______________

Are there any errors or corrections needed on the Death Certificate?
                                                                        Yes __ No ___
Has or will any disclaimer been filed by a beneficiary of the Will?
 If so, attach copy  Yes _ No _

What questions do you have? Write down below.  How can we help you?
Is there anything else important?

______________________________________________________

______________________________________________________

______________________________________________________

New clients:    When you come into the office would you like:

T-Shirt __, Pens ___, Foam can holder ___,  USA key chain ___, Calendar ___
         Please pick in reception area. All new clients will also receive our Free Email Newsletter featuring updates in Probate, Traffic Law, and Personal Injury/ Insurance.   Thank you.     
1.  Attach a photocopy (not original) of the  Will, 
2.  Death Certificate, 

3.  codicils, trusts. This is required by the Surrogate's Office (Tax Bureau). In the future will also need photocopies of the Deed and Tax Bill to submit to the Inheritance Tax Bureau. 

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