| Your
Name |
|
| Your Email Address |
|
| Contact Phone
|
|
Contact Fax |
|
| Beneficiary's
Name |
|
| |
|
|
|
Estate Information Worksheet
|
|
| |
|
|
|
| Name of
Deceased |
|
| Relationship to
you |
|
Date Of Death |
|
|
Did the Deceased have a Will? |
Yes
No |
Is there a Trust |
Yes
No |
| Any
distributions to date? |
Yes
No |
If "Yes", the dollar amount |
|
| Have you borrowed
against your future inheritance? |
Yes
No |
|
| If "Yes", what
is the amount |
|
Est.
Inheritance value |
|
| Advance amount
request |
|
Location of Estate (State) |
|
| Name Executor
or Administrator |
|
| Executor /
Administrator Email |
|
| Executor /
Administrator Phone |
|
|
|
| Estate
Attorney's Name |
|
| Estate
Attorney's Email |
|
| Name of Law
Firm |
|
| Why are you
seeking this advance of funds against the estate? |
|
| |
|
|
|
|
Please answer the math
question. The sum of 9 + 3 = |
|
|
| |
|
|
|
|
|
