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PROBATE & TRUST ADMINISTRATION INTAKE SHEET

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?

LAST WILL DATE:

CODICIL DATE:

TRUST DATE:

AMENDMENT DATE:

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?

Yes No

IF SO, DID THAT DECEASED CHILD HAVE ANY CHILDREN?

Yes No

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?

Yes No

IF THE DECEDENT DID NOT HAVE CHILDREN, ARE THERE SURVIVING PARENTS ?

Yes No

IF YES, PLEASE PROVIDE THEIR INFORMATION BELOW.

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 #:

7807 E Peakview Ave., Suite 410, Centennial, CO 80111
Direct Phone: (303)409.3559 or FAX No.: (303) 409-3556
Main Office Phone; (303)409.3559

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