"Last Will and Testament Worksheet Template"

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LAST WILL AND TESTAMENT WORKSHEET
Please fill out this form as best as you can. If you have any questions, please call feel free to call our
office at 402-477-2233.
Name:
DOB:
Spouse:
DOB:
Address:
City/State/Zip Code
Home Phone:
Work Phone:
Cell Phone:
E-mail address:
Social Security Number:
Name(s) of Child(ren), Address, Phone Number and Date of Birth:
After spouse and children, who should receive property:
Designated Gift list:
yes
no Where kept: Attorney; ______ Other:
First Personal Representative: Spouse: _____; Other:
Second Personal Representative and address:
If a Guardian needed – Name and Address:
Secondary Guardian – Name and Address:
Charitable Bequests:
Durable Power of Attorney:
Husband to Wife or
____ Yes
Husband to
____ Yes
Wife to Husband or
____ Yes
Wife to
____ Yes
Health Care Power of Attorney:
First (Name):
Second (Name):
Living Will:
____ Yes
____ No
If you wish to have a trust, please complete the following:
Name of Trust:
Age to Pay Out Trust:
Trustee (Name and Address):
Secondary Trustee (Name and Address):
Financial Planner:
Life Insurance:
You should have in mind the value of your estate (assets and liabilities). If you have a financial sheet,
please provide it.
Jim Cada, Ed Hoffman & Linda Jewson
Cada, Cada, Hoffman & Jewson
1024 K Street
Lincoln, NE 68508
Rev 2.27.15
LAST WILL AND TESTAMENT WORKSHEET
Please fill out this form as best as you can. If you have any questions, please call feel free to call our
office at 402-477-2233.
Name:
DOB:
Spouse:
DOB:
Address:
City/State/Zip Code
Home Phone:
Work Phone:
Cell Phone:
E-mail address:
Social Security Number:
Name(s) of Child(ren), Address, Phone Number and Date of Birth:
After spouse and children, who should receive property:
Designated Gift list:
yes
no Where kept: Attorney; ______ Other:
First Personal Representative: Spouse: _____; Other:
Second Personal Representative and address:
If a Guardian needed – Name and Address:
Secondary Guardian – Name and Address:
Charitable Bequests:
Durable Power of Attorney:
Husband to Wife or
____ Yes
Husband to
____ Yes
Wife to Husband or
____ Yes
Wife to
____ Yes
Health Care Power of Attorney:
First (Name):
Second (Name):
Living Will:
____ Yes
____ No
If you wish to have a trust, please complete the following:
Name of Trust:
Age to Pay Out Trust:
Trustee (Name and Address):
Secondary Trustee (Name and Address):
Financial Planner:
Life Insurance:
You should have in mind the value of your estate (assets and liabilities). If you have a financial sheet,
please provide it.
Jim Cada, Ed Hoffman & Linda Jewson
Cada, Cada, Hoffman & Jewson
1024 K Street
Lincoln, NE 68508
Rev 2.27.15