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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