(New) Estate Plan Questionnaire 2025 | The Law Office of Kelly T. Braun, PLLC
The information requested in this form is kept confidential. Providing this personal information about you, your family, and your assets, before we meet is helpful to make the most of our time when discussing your estate plan options. Thank you for taking the time. I look forward to talking with you soon, Kelly PLEASE NOTE: No attorney-client relationship with Kelly T. Braun or The Law Office of Kelly T. Braun, PLLC is created by completing and submitting this form. If you have any issues submitting this form, please email me at kelly@ktbraunlaw.com.
Today's Date
Who is the estate plan for?
An individual (single; divorced; widowed)
A married couple
To be determined
What estate plan documents do you currently have? (check all that apply)
Will
Revocable Living Trust
Other type of Trust
General (Financial) Power of Attorney
Medical / Healthcare Power of Attorney
None
Unsure
(Ladybird) Deed
What would you like to discuss? (check all that apply)
New estate plan (Will, Trust, Powers of Attorney, etc.)
Review/update existing estate plan (less than 5 years old)
Review/update existing estate plan (more than 5 years old)
Healthcare Power of Attorney and HIPAA Authorization
General Power of Attorney (financial, personal affairs)
Deed to transfer property / Ladybird Deed
Powers of Attorneys for our "children" (Young adult 18+)
Certificate of Trust
Estate Administration / Probate
Something else
Have you previously worked with The Law Office of Kelly T. Braun, PLLC
Yes, on an estate plan
Yes, on something else
No
(Person 1) First, Middle, Last Name
(Person 1) Email Address
(Person 1) Phone Number
Preferred Methods for Communication (check all that apply)
Email
Text Messages
Phone call
Any method of communication
Address (Street, City)
(Person 1) Date of Birth
(Person 1) Marital Status
Current Marital Status
Married - first marriage
Married - second+ marriage
Single - never married
Single - widow(er)
Single - divorced
I have a significant other/partner
(Person 1) General Information (check all that apply to Person 1)
Employed
Retired
US Citizen
Veteran
Receiving Medicaid or other government benefits
Chronic health disease/significant medical issues
(Spouse) First, Middle, Last Name
(Spouse) Email address
(Spouse) Phone Number
(Spouse) Marital Status
Current Marital Status
Married - first marriage
Married - second+ marriage
Spouse's Date of Birth
(Spouse) General Information (check all that apply to Spouse)
Employed
Retired
US Citizen
Veteran
Receiving Medicaid or other government benefits
Chronic health disease/significant medical issues
Children and Grandchildren (check all that apply)
No children
Child on the way
Child(ren) under 18 and over 18 year old
Minor children (under 18) only
Adult children (over 18) only
Child(ren) from a previous relationship - Person 1
Child(ren) from a previous relationship - Spouse
No grandchildren
Grandchildren
What are the full names and birthdates of ALL of your child(ren)?
What are the names and birthdates of ALL of your Grandchild(ren)?
Any concerns or issues with your Children or Grandchildren (spending habits, bad relationship, addiction, special needs, etc.)
Special Needs Child or Grandchild
Addiction Issues
Responsibility Concerns (financially immature, other)
Financially Support Adult Child(ren) / Grandchildren
NO issues / concerns
N/A - I/we DO NOT have children or grandchildren
Person 1 - Extended (Living) Family Members (Select all living family members)
Mother
Father
Sister(s)
Brother(s)
Step or Half Sibling(s)
Step Mother or Father
N/A - Person 1 has no living family members
Spouse - Extended (Living) Family Members
Mother
Father
Sister(s)
Brother(s)
Step or Half Sibling(s)
Step Mother or Father
N/A - Spouse has no living family members
Concerns or issues with family members?
Nothing out of the ordinary
There are family members that I/we want to disinherit (omit from my/our estate plan)
There are family members that I/we would not want involved in the administration of our estate
Something else
Real Estate (Primary Residence)
Owned Individually
Owned Jointly with Spouse
Owned Jointly with Other(s)
I/we rent
Real Estate (Primary Residence Market Value)
less than $100,000
$100k - $349k
$350k - $499k
$500k - $749K
$750k +
I/we have a mortgage on this property
I/we do not have a mortgage on this property
N/A - I/we do not own any real estate
Additional Real Estate
Owned Individually (in Michigan)
Owned Jointly with Spouse (in Michigan)
Owned Jointly with Other(s) (in Michigan)
Owned outside of Michigan
I/we have a mortgage on this property
I/we do not have a mortgage on this property
Additional Real Estate (Market Value)
less than $100,000
$100k - $349k
$350k - $499k
$500k - $749k
$749k+
(Person 1 ) Which types of these accounts do you have? (check all that apply)
Checking Account(s) - Individually owned
Savings Account(s) - Individually owned
Money Market Account(s)/CDs - Individually owned
Checking Account(s) - owned Jointly
Savings Account(s) - owned Jointly
Money Market Account(s)/CDs - owned Jointly
I/we do not have any checking, savings, CDs, or money market accounts
If married, I/we have joint account(s) with someone other than Spouse
Approximate Total Value of Checking, Savings, Money Market/CD Accounts (identified above)
under $5,000
$5,000 - $10k
$10k - $25k
$25k - $50k
$50k - $100k
$100k - $500k
$500k +
N/A - I/we do not own these types of accounts
(Person 1) Which of these Retirement Accounts do you have?
IRA (Traditional)
IRA (Roth)
IRA (SEP)
401(k), 403(b), 457(b)
N/A - Person 1 does not have Retirement Accounts
Pension
(Person 1) Approximate Total Value of Retirement Accounts
less than $25,000
$25,000 - $100,000
$100,000 - $350,000
$350,000 - $500,000
$500,000 - $1M
$1M - $5M
more than $5M
more than $11M
N/A - Person 1 does not have Retirement Accounts
(Spouse) Which of these Retirement Accounts do you have?
IRA (Traditional)
IRA (Roth)
IRA (SEP)
401(k), 403(b), 457(b)
N/A - Spouse does not have Retirement Accounts
Pension
(Spouse) Approximate Total Value of Retirement Accounts
less than $25,000
$25,000 - $100,000
$100,000 - $350,000
$350,000 - $500,000
$500,000 - $1M
$1M - $5M
more than $5M
more than $11M
N/A - Spouse does not have Retirement Accounts
(Person 1) What Insurance do you have?
Whole Life
Term Life
Annuity
N/A - Person 1 does not have Annuities or Life Insurance
Long-term Healthcare Policy
(Person 1) What is Total Value of Insurance and Annuity
Person 1's Total Value - Insurance and Annuity
less than $25,000
$25,000 - $100k
$100k - $500k
$500k - $1m
$1m +
N/A - Person 1 does not have Annuities or Life Insurance
(Spouse) What Insurance do you have?
Whole Life
Term Life
Annuity
N/A - Spouse does not have these assets
Long-term Healthcare Policy
(Spouse) What is Total Value of Insurance and Annuity?
Spouse's Total Value - Insurance and Annuity
less than $25,000
$25,000 - $100k
$100k - $500k
$500k - $1m
$1m +
(Person 1) Other Assets
Stocks
Bonds
HSA (Health Savings Account)
529 (other educational accounts)
Interest in a Business
Vehicles (owned not leased)
Boats (owned not leased)
Promissory Note; Contracts evidencing money owed me/us
No Additional Assets
Something else
Approximate value of Other Assets - less than $50k
Approximate value of Other Assets - $50k-$100k
Approximate value of Other Assets - $100k-$500k
Approximate value of Other Assets - $500k+
(Spouse) Other Assets
Stocks
Bonds
HSA (Health Savings Account)
529 (other educational accounts)
Interest in a Business
Vehicles (owned not leased)
Boats (owned not leased)
Promissory Note; Contracts evidencing money owed me/us
No Additional Assets
Something else
Approximate value of Other Assets - less than $50k
Approximate value of Other Assets - $50k-$100k
Approximate value of Other Assets - $100k-$500k
Approximate value of Other Assets - $500k+
Do you have pets?
Yes and want to include provisions for their care in the estate plan
Yes but do not want or need provisions for them in the estate plan
No pets
Ideal beneficiaries of your (assets) estate?
Spouse
Children under age 18
Children over age 18
Parents
Nieces/Nephews
Friends
Charity
Other
Do you work with a Financial Advisor?
Yes
No
I would like a recommendation for a financial advisor
Do you work with a CPA?
Yes
No
I would like a recommendation for an accountant or CPA
How did you hear about The Law Office of Kelly T. Braun, PLLC?
How did you hear about The Law Office of Kelly T. Braun, PLLC?
A family member
A previous client of this Firm
A friend
Facebook
Instagram
Rochester Regional Chamber of Commerce
My/our CPA
My/our Financial Advisor
Another Lawyer
Google search
Attended a seminar where Kelly presented
Other
How soon would you like to complete (or update) your estate plan?
Ideal time frame to get started?
Now - ready to begin the process
ASAP - need to have this completed by a certain date
Within the next couple of months
Not sure - just researching now
What do you want to accomplish with your estate plan? (check all that appy)
Avoid "after death" probate court (assets pass to beneficiary without court supervision)
Nominate a guardian for minor child(ren)
Appoint someone to handle my personal/financial matters when I cannot because of absence or incapaci
Appoint someone to handle my medical care (and/or relay DNR wish) if I am unable
Assist children, loved ones, family by providing directions
Peace of Mind
Avoid a similar situation that I dealt with
Make arrangements for a family cottage
Exclude family members as possible beneficiaries or agents
Someone told me a horror story
It is just time
I/we understand that an attorney-client relationship is not created with attorney Kelly T. Braun or The Law Office of Kelly T. Braun, PLLC by completing and submitting this form.
(Person 1) Signature
*
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(Spouse) Signature
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DONE! SUBMIT QUESTIONNAIRE
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