CALL FOR A FREE CASE EVALUATION

(877) 315-5107

PROBATE INTAKE FORM

Please complete this form with the requested information and bring with you to meet with us. The information provided will be required before filing a petition before the court. If you are unsure of any information requested, please so indicate.

Client Information

Name

Address:

Home Phone:

Work phone:

Cell phone:

Email Address:

Birth Date:

SS#:

Employer:

Occupation:

Relationship to Decedent:

Decedent Information

Name:

Residence:

Date of Death:

Place of Death:

Age:

Cause of death:

Did decedent sign a Will? If yes, please bring original. DO NOT REMOVE STAPLES

Address of Real Property/Properties Owned by Decedent:

Financial Accounts Owned by Decedent and Values (List any joint tenants or beneficiaries):

Life insurance policies, values and beneficiaries:

Name of Funeral Home:

Funeral Cost:

Paid by whom?

Decedent Family Information (Name and Address for each. If deceased, list date of death.)

Mother:

Father:

Spouse:

Children (Indicate son/daughter – If a son or daughter is deceased, list his or her children):

Siblings (Indicate brother/sister – If a brother or sister is deceased, list his or her children):