Will Questionnaire

1. General Information:
Last Name		
First Name		
Middle 		
Jr, Sr, II?		
Date of Birth		
SSN		
U.S. Citizen?		
Street Address		
City, State, Zip		
County		
Home Phone		
Occupation		
Employer		
Work Address		
Work Phone/Fax		
Email		

Hyatt Legal Plan case number, if applicable.		
Do you have children?		
What are your children’s names and birthdates?                 		
Child 1		
Child 2		
Child 3		
Do you plan on having children?		

2. Who would you like to be Executor of you Estate?

First Choice
Name		
Street Address		
City, State, Zip		
Phone Number		
Relationship		

First Alternative
Name		
Street Address		
City, State, Zip		
Phone Number		
Relationship		

Second Alternative
Name		
Street Address		
City, State, Zip		
Phone Number		
Relationship		

3. To whom would you like to leave your property?
Name of Person	Percent of Property	

		

4. If any Beneficiary under your will predeceases you, to whom would you like to leave the deceased beneficiaries share of your property?
Name of Beneficiary		
Equally among the surviving beneficiaries?  Y/N?		
To the descendant’s of the deceased beneficiary? Y/N?		
First to deceased beneficiary’s children, but if none, then equally among the surviving beneficiaries? Y/N?		
Other, Please explain

5. Do you want to include a “no contest”clause in your will?
If any beneficiary named in your will contests the will, they will lose all his or her inheritance rights under your will if they challenge it.

______Yes     _______No

6. Do you want your Executor/Executrix to be compensated for their services of probating your will/estate?

______Yes    _______No

7. Trustee of any minor beneficiary
If any beneficiary stands to inherit from you when he or she is still a minor, the trustee will hold and manage the minor beneficiary’s inheritance for the benefit of the minor beneficiary. 
First Choice
Name		
Relationship		
Street address		
City, State, Zip		
Home Phone		

First Alternative
Name		
Relationship		
Street address		
City, State, Zip		
Home Phone		
Second Alternative
Name		
Relationship		
Street address		
City, State, Zip		
Home Phone		

8. Medical Power of Attorney
Under a medical power of attorney, the agent has the authority to make any health care decision on your behalf if you are incapacitated. Health care decision means consent, refusal to consent, or withdrawal of consent to health care, treatment, service, or procedure to maintain, diagnose, or treat, your physical or mental health condition.

First Choice for agent
Name		
Relationship		
Street address		
City, State, Zip		
Home Phone		

First Alternative
Name		
Relationship		
Street address		
City, State, Zip		
Home Phone		

Second Alternative
Name		
Relationship		
Street address		
City, State, Zip		
Home Phone		

9. General Power of Attorney
A power of attorney is the transfer of the authority of one person to act in the place of another as attorney in fact if you are incapacitated.  An attorney in fact has a broad power to act for you within defined matters.  
First Choice
Name		
Relationship		
Street address		
City, State, Zip		
Home Phone		

First Alternative
Name		
Relationship		
Street address		
City, State, Zip		
Home Phone		

Second Alternative
Name		
Relationship		
Street address		
City, State, Zip		
Home Phone		

10. Guardian of person
In the event of your future incapacity, your guardian will have responsibility for your care, control and protection.  The guardian will decide where you live and you generally cannot receive medical care without the consent of your guardian.
First Choice
Name		
Relationship		
Street address		
City, State, Zip		
Home Phone		
First Alternative
Name		
Relationship		
Street address		
City, State, Zip		
Home Phone		

Second Alternative
Name		
Relationship		
Street address		
City, State, Zip		
Home Phone		

11. Guardian of estate
In the event of your future incapacity, the guardian of your person will have the legal authority and duty to manage your property, collect your income, and represent you in legal matters. 

First Choice
Name		
Relationship		
Street address		
City, State, Zip		
Home Phone		

First Alternative
Name		
Relationship		
Street address		
City, State, Zip		
Home Phone		

Second Alternative
Name		
Relationship		
Street address		
City, State, Zip		
Home Phone		

12. Guardian of your children’s person. 
If you do not have children and do not plan to have children, skip this question and question 13.  If both parents of your children die while the children are under the age of 18, the guardian of the person will the have the care, control and protection of the minor children.  Two people can serve as guardian of the children only if they are married. 
First Choice
Name		
Relationship		
Street address		
City, State, Zip		
Home Phone		

First Alternative
Name		
Relationship		
Street address		
City, State, Zip		
Home Phone		

Second Alternative
Name		
Relationship		
Street address		
City, State, Zip		
Home Phone		

13. Guardian of the estate of your children 
If both parents die while the child is under 18, the guardian of the child’s estate will have the legal authority and duty to help manage the child’s property, collect the child’s income and represent the child in legal actions.  In Texas, even a surviving parent must apply to be a guardian of the child’s estate if the child receives an inheritance.

First Choice
Name		
Relationship		
Street address		
City, State, Zip		
Home Phone		

First Alternative
Name		
Relationship		
Street address		
City, State, Zip		
Home Phone		

Second Alternative
Name		
Relationship		
Street address		
City, State, Zip		
Home Phone