Law Office of Thomas F. Sammons, 502 N. Plum Grove, Palatine, IL 60067
Phone 847-359-9610 Fax 847-359-1581 e-mail: tom@lawsam.com
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Your Name: DOB Spouse:
DOB |
Address: |
Phone: (h) (w) e-mail: |
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Children: |
Age(s) |
Town and State if not living with you: |
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Are you a US Citizen? Yes___ No___ |
Have you been divorced? Yes___ No____ |
Do you have a prior will or trust? Yes___ No___ |
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How is your health? Good___________ Average_________ Poor____________ |
Other concerns: |
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Asset: |
Amount |
Name on
account/beneficiary |
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Life Insurance: |
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Retirement
(includes 401ks, IRAs, Roth IRA): |
Amount |
Name on
Account/Beneficiary |
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Investment
Accounts, Mutual Funds, Stocks and Bank Accounts, CDs |
Amount |
Name(s) on
account |
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Real Estate
(Address) |
Value/Mortgage
Amt. |
Names on title |
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Trustee for
Heirs/Children:
The trustee manages money for your children. (Note: This can be the same person as the guardian or someone else. It should be someone reliable who uses good judgment.) The trustee acts for a longer time than the guardian, usually until the youngest child is at least age 25.
Power of Attorney
for Health Care
The person who will make health decisions for me if I could not is:
Other issues:
I want to leave
funds to charity
Yes___ No___ Maybe_____
I want to leave
funds to grandchildren
Yes___ No___ Maybe____
I am concerned about
the ability of a child of mine to manage money
Yes__ No __Maybe___
A child of mine has
a disability
Yes__ No __
If
you have no children under age 25, you are done. Please call for a free consultation and bring this form to the
appointment. Thanks for taking the time to complete the information sheet.
If you have young children, or children under age 25, please complete the next pages.
Guardian of Minor
Children:
If your children are under age 18 who will be their guardian, that is the person they live with and who makes legal decisions for them until age 18?
( Note: We do not suggest picking a “couple” as guardian. The guardian should be the person, usually a relative, that you want. There is no need to name the guardian’s spouse as co-guardian):
Terms of Trust for Children under 25
If your children are under age 25, the trustee for the children’s health, support and education usually makes funds available. The children’s trust rider below is used to tell the trustee how to spend money for your children’s education, weddings, cars, etc. Ranking an item One (1) means it is a low priority for you and a ten (10) means a high priority. Each item can be a 10, they do not need to be ranked 1-10. Please insert your ranking for each item and any comments.
Guideline/Purpose
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Rating
each item 1-10 (1
is low priority, 10 is high priority) |
Comments
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Private
School Before College |
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Post
graduate education |
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Tuition,
Room and board while in college |
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Car
at first age at which child can drive |
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Car
after college |
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Down
Payment on Business |
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Down
Payment on a Home |
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Payment
for first wedding |
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Principal left to
distribute at end of trust |
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Funds
to improve Guardian’s home |
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All trusts need an end point. Generally, we suggest distributing to the children no sooner than age 25. The funds can be distributed as early as age 18, but usually the child is too young for a large distribution. Of course, the trustee is paying for their benefit until the distributions are made. Please indicate the percentage of the trust that you want distributed at the specified age. The ages below are just suggestions. Please use any other age that you wish. The ages below are just suggestions. The trust for my children will end at these ages:
25_____(%) 30______(%) 35_____(%)