Date:
HOW WERE YOU REFERRED TO OUR FIRM?
DECEDENT’S INFORMATION:
NAME:
ALSO KNOWN AS:
RESIDENCE:
COUNTY:
AGE:
DATE OF DEATH:
DATE OF BIRTH:
SSN#
MARITAL STATUS:
HOW MANY CHILDREN?
DECEDENT’S SPOUSE INFORMATION:
NAME:
SSN:
ADDRESS:
IF DECEASED, DATE OF DEATH:
IF DIVORCED, YEAR:
PHONE #:
IF SEPARATED, YEAR:
PERSONAL REPRESENTATIVE/TRUSTEE:
NAME:
ADDRESS:
PHONE #:
EMAIL:
DOB:
SSN:
PERSONAL REPRESENTATIVE/TRUSTEE:
NAME:
ADDRESS:
PHONE #:
EMAIL:
DOB:
SSN:
. . . . . . . . . . . . . .
DECEDENT’S CHILDREN (INCLUDING ADOPTED CHILDREN) INFORMATION:
NAME:
AGE:
ADDRESS:
IF DECEASED, DATE OF DEATH:
PHONE #:
ADOPTED, DATE:
NAME:
AGE:
ADDRESS:
IF DECEASED, DATE OF DEATH:
PHONE #:
ADOPTED, DATE:
NAME:
AGE:
ADDRESS:
IF DECEASED, DATE OF DEATH:
PHONE #:
ADOPTED, DATE:
NAME:
AGE:
ADDRESS:
IF DECEASED, DATE OF DEATH:
PHONE #:
ADOPTED, DATE:
NAME:
AGE:
ADDRESS:
IF DECEASED, DATE OF DEATH:
PHONE #:
ADOPTED, DATE:
. . . . . . . . . . . . . .
DID THE DECEDENT HAVE ANY CHILDREN THAT PRE-DECEASED?
IF SO, DID THAT DECEASED CHILD HAVE ANY CHILDREN?
IF YES, PLEASE PROVIDE THEIR INFORMATION BELOW.
NAME:
AGE:
ADDRESS:
IF DECEASED, DATE OF DEATH:
PHONE #:
NAME:
AGE:
ADDRESS:
IF DECEASED, DATE OF DEATH:
PHONE #:
NAME:
AGE:
ADDRESS:
IF DECEASED, DATE OF DEATH:
PHONE #:
NAME:
AGE:
ADDRESS:
IF DECEASED, DATE OF DEATH:
PHONE #:
. . . . . . . . . . . . . .
DID THE DECEDENT HAVE ANY CHILDREN OF A PREVIOUS MARRIAGE?
IF THE DECEDENT DID NOT HAVE CHILDREN, ARE THERE SURVIVING PARENTS ?
IF YES, PLEASE PROVIDE THEIR INFORMATION BELOW.
NAME:
ADDRESS:
PHONE #:
NAME:
ADDRESS:
PHONE #:
. . . . . . . . . . . . . .
IF THE DECEDENT HAS NO SPOUSE, NO CHILDREN AND NO SURVIVING PARENTS, PLEASE PROVIDE NAMES AND ADDRESSES OF THE DECEDENT’S SIBLINGS.
NAME:
AGE:
ADDRESS:
IF DECEASED, DATE OF DEATH:
PHONE #:
NAME:
AGE:
ADDRESS:
IF DECEASED, DATE OF DEATH:
PHONE #:
NAME:
AGE:
ADDRESS:
IF DECEASED, DATE OF DEATH:
PHONE #:
. . . . . . . . . . . . . .
IF THERE ARE DECEASED SIBLINGS, PLEASE PROVIDE NAMES AND ADDRESSES OF DECEASED SIBLINGS CHILDREN.
NAME:
AGE:
ADDRESS:
IF DECEASED, DATE OF DEATH:
PHONE #:
NAME:
AGE:
ADDRESS:
IF DECEASED, DATE OF DEATH:
PHONE #:
NAME:
AGE:
ADDRESS:
IF DECEASED, DATE OF DEATH:
PHONE #:
. . . . . . . . . . . . . .
OTHER BENEFICIARIES (THOSE NOT RELATED/NOT HEIRS) CHARITIES OR SPECIFIC DEVISES NAMED IN THE WILL.
NAME:
ADDRESS:
PHONE #:
NAME:
ADDRESS:
PHONE #:
3801 E. Florida Ave., Suite 640, Denver, CO 80210
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