Confidential Estate Planning Questionnaire for Married Persons / Partners

This questionnaire will assist your von Briesen & Roper, s.c. attorney in identifying the tax and non-tax issues relevant to your estate plan. Estimates rather than exact figures should suffice for the financial information. If you prefer, you may attach a recent financial statement which includes information requested in the personal financial statement section and fill in the remaining items as needed.

First NameMiddle NameLast Name

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Please enter a valid phone number.Format: (000) 000-0000.

First NameMiddle NameLast Name

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Please enter a valid phone number.Format: (000) 000-0000.

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

The following is a brief description of the positions that need to be addressed in estate planning documents. Please consider whom you may want to name and provide addresses and phone numbers for those whom you expect to include. We will discuss this more fully during our meeting before any final decisions are made.

Personal Representatives

The Personal Representative manages property that is titled in your name and does not pass by joint ownership, beneficiary designation or other nonprobate court mechanism. If a probate proceeding is necessary, the Personal Representative manages your debts, taxes, and distributions to beneficiaries. If using a Revocable Living Trust as your primary estate planning tool, most duties shift to the Trustee(s), which is why many people name the same person(s) or trust company for both roles, and more than one Personal Representative can be named.

Trustees

If you include a Revocable Living Trust in your plan, Trustees manage funds held in or transferred to the trust and distribute assets according to trust provisions after your death or disability, and more than one Trustee can be named. Any individual over 18 or a trust company can serve as Trustee regardless of residency, and you can initially serve as Trustee of your own Revocable Trust.

Agent for Health Care Power of Attorney

An agent under a Health Care Power of Attorney will make health care decisions for you if you become incapacitated. You may name a successor agent if your primary agent cannot serve but you cannot name co-agents.

Attorneys in Fact for Durable Power of Attorney for Financial Matters

Agents under a Durable Financial Power of Attorney are granted broad powers to manage your personal and financial matters during your lifetime, including signing checks, dealing with social security issues, managing your retirement accounts, and filing taxes. This authority can be granted either upon execution of the document or only in the event you become unable to handle your finances. Multiple agents can be named to serve in this role.

Guardians

Disregard this section if there are no minor children. If any children are under age 18, Guardian(s) will be responsible for their day-to-day care and living arrangements. Guardians need not be Wisconsin residents, and more than one Guardian can be named.

If you have certain people in mind to fill these roles, please include their names, addresses and phone numbers.

Completing this summary with the approximate value of your assets and liabilities will assist us in developing your overall estate plan, assessing your needs for tax planning, and anticipating situations that might arise upon your death. Although detailed information regarding each and every asset is not required at this stage, providing more detailed information requested in the enclosed schedules will be extremely helpful. If you have a recent financial statement, you may attach that instead.

NOTE: If you have a current financial statement prepared by your financial advisor, accountant, or other agent, you may attach that rather than filling out the following tables.

Rows	Client #1	Client #2	Joint
Tangible Personal Property (Schedule A)
Cash & Notes Receivable (Schedule B)
Real Estate (Schedule C)
Securities (Schedule D)
Proprietorships/Partnerships (Schedule E)
Closely-Held Businesses (Schedule F)
Life Insurance Death Benefit (Schedule G)
Retirement Assets/Plans (Schedule H)
Stock Options (Schedule I)
Miscellaneous (Schedule J)
Guns (NFA Regulated Firearms)
Cryptocurrencies
Total

Rows	Client #1	Client #2	Joint
Mortgages (Schedule K)
Loans/Notes Payable (Schedule K)
Other Liabilities (Schedule K)
Totals

Rows	Client #1	Client #2	Joint
Estate Net Worth (Assets-Liabilities)

Rows	Client #1 ($)	Client #2 ($)	Joint/Community ($)
Furniture and Furnishings
Automobiles
Works of Art or Art Collections
Other Collections
Jewelry and Furs
Other
Totals

Rows	Approximate Cost Basis ($)	Client #1 ($)	Client #2 ($)	Joint ($)
Brokerage Accounts:
Publicly Traded Stocks:(held directly with company)
Mutual Funds
Corporate Bonds
U.S. Government Bonds/Notes/Bills
Municipal Bonds
Other
Totals:

Confidential Estate Planning Questionnaire for Married Persons / Partners

General Information

Personal Information

Client #1

Client #2

Children

Prior Marriages

Client #1

Client #2

Documents and Advisors

Background Information

Financial Information

Schedule A - Tangible Personal Property

Schedule B - Cash Equivalents & Notes Receivable

Schedule C - Real Estate

Schedule D - Securities

Schedule E - Partnerships and Tax Shelters

Schedule F - Closely-Held Business Interest

Schedule G - Life Insurance

Schedule H - IRAs, 401(k)s, and Other Retirement Assets/Plans

Schedule I - Employer Granted Stock Options and Restricted Stock

Schedule J - Miscellaneous

Schedule K - Liabilities