COMPLEX LAST WILL & TESTAMENT INFORMATION SUMMARY AND INQUIRY TO SPIEGEL & UTRERA, P.A.
OUR GOAL—YOUR Complete Satisfaction and UnderstandingShould you order this document from Spiegel & Utrera, P.A., Spiegel & Utrera, P.A., will incorporate your basic information into a draft document that will be conveyed to you for your review and make reasonable changes upon request.
Please complete where applicable
Name:	*required
City:
State:
Telephone:	*required
Cellular Phone:
Fax:
Email:	*required
What do some of these terms mean? Click here for a Glossary.
Testator or Testatrix's Name:
Testator or Testatrix's Social Security Number:
Spouse of Testator or Testatrix
Spouse of Testator or Testatrix's Social Security Number:
Testator or Testatrix's Telephone Number:
Testator or Testatrix's Fax Number:
Testator or Testatrix's Email:
Testator or Testatrix's Address:
Testator or Testatrix's Street:
Testator or Testatrix's City:
Testator or Testatrix's State:
Testator or Testatrix's Zip Code:
Testator or Testatrix's Mailing Address:
Testator or Testatrix's Mailing Street:
Testator or Testatrix's Mailing City:
Testator or Testatrix's Mailing State:
Testator or Testatrix's Mailing Zip Code:
LAST WILL & TESTAMENT
Name of Last Will & Testament Personal Representative, Executor or Executrix:
Optional Address of Last Will & Testament Personal Representative, Executor or Executrix:
Last Will & Testament Personal Representative, Executor or Executrix's Relationship to Testator or Testatrix:
Last Will & Testament Personal Representative, Executor or Executrix's Telephone Number:
Special Instructions to Last Will & Testament Personal Representative, Executor or Executrix:
Name of Successor Last Will & Testament Personal Representative, Executor or Executrix:
Optional Address of Last Will & Testament Personal Representative, Executor or Executrix:
Successor Last Will & Testament Personal Representative, Executor or Executrix's Relationship to Testator or Testatrix:
Successor Last Will & Testament Personal Representative, Executor or Executrix's Telephone Number:
Special Instructions to Successor Last Will & Testament Personal Representative, Executor or Executrix:
Name of Beneficiary 1 of Last Will & Testament:
Optional Address of Beneficiary 1 of Last Will & Testament:
Beneficiary 1's Relationship to Testator or Testatrix:
Beneficiary 1's Percentage
Name of Beneficiary 2 of Last Will & Testament:
Optional Address of Beneficiary 2 of Last Will & Testament:
Beneficiary 2's Relationship to Testator or Testatrix:
Beneficiary 2's Percentage
Name of Beneficiary 3 of Last Will & Testament:
Optional Address of Beneficiary 3 of Last Will & Testament:
Beneficiary 3's Relationship to Testator or Testatrix:
Beneficiary 3's Percentage
Name of Beneficiary 4 of Last Will & Testament:
Optional Address of Beneficiary 4 of Last Will & Testament:
Beneficiary 4's Relationship to Testator or Testatrix:
Beneficiary 4's Percentage
ASSETS - Please indicate the assets held by the Testator or Testatrix below and describe as applicable
Residence/Home (Please provide a short description including the names(s) of the owner(s) that hold title, mortgage(s) (quantity and amount(s)), location (city and state), and approximate value).
Other Real Estate (Please provide a short description including the names(s) of the owner(s) that hold title, mortgage(s) (quantity and amount(s)), location (city and state), and approximate value).
Cash and cash equivalents (Please provide a short description including the name(s) of the account owner(s), location (city and state), and approximate value).
Investments
Life Insurance
IRA Accounts
Other Retirement Accounts
Notes, Mortgages and Obligations
Other Assets or Income
Other Property (car, boat, motorcycle, antiques)
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