Title DR MISS MR MRS MS First Name * Last Name * Email Address *
Name of Deceased Last Home Address of Deceased: Place of Death: Date of Death: Deceased's Birth Date: Deceased's Social Security Number: How long did deceased reside at last address? Surviving Spouse Surviving Spouse's Home Address: Surviving Spouse's Telephone Number Surviving Spouse's Social Security Number: Surviving Spouse's Birth Date: Date of Marriage: Previous Spouse(s): Date Marriage(s) Dissolved and How: Children of Deceased and any other beneficiaries - For each, list: name, address - including zip code, relationship, date of birth. List any children who have died before the deceased, giving their date of death. If a child was adopted, please note.
Is there a will, if so, where is it? Did the deceased have a bank box? If so, where is it located (name of bank): Real Estate (Home or other) We will need a complete property description including book and page number (which can be obtained from the mortgage or deed) and the value of each piece of property.
Bank Accounts (We will need: name of bank; type of account; account number; name account is in; balance in account as of date of death of the decedent) Decedent's interest in any business: Are there any sub-chapter S corporations? Savings and loan or credit union accounts (We will need: name of bank; type of account; account number; name account is in; balance in account as of date of death of decedent) Annuities (list only if there is no beneficiary or if beneficiary is the estate) Thrift Funds U.S. Bonds, please bring copies of all bonds- we need serial number, date of issue and value.
Other bonds Stocks Unpaid Salary Accounts receivable Rents receivable Notes receivable Cash on hand Oil/ Gas Wells (we will need copies of the death certificate and please list location, parish/ county, state, name of company, owner number) Automobiles, Trailers, Boats (We will need: year, make, model, VIN, and the value of the vehicle). If you have the vehicle Title or Certificate of Registration we will need a copy of it. If you cannot provide us with a value for each vehicle, we will need Tools, firearms (give values) Antiques (give values) Jewelry (give values) Furniture (give values) Coins, art, collections (give values) Claims or intangibles (give values) Claims or intangibles (give values) Escrows or deposits Deferred Compensation Agreements Misc. Assets Mortgages on home, autos, or other property (We will need: name of lien holder and balance on mortgage; also specify if there is credit life insurance) Signature loans at banks or other institutions (We will need: name of institution and balance on loan; also specify if there is credit life insurance) Current debts (utilities, credit card debts, etc.) (Please give amount of debt as of date of decedent's death) Medical & Other expenses of last illness Funeral expenses (Specify if burial insurance, social security, or veteran's benefits) Any other debts incurred prior to death Contingent liabilities Was decedent a trustee of any trust or other fiduciary (tutor, executor, administrator) Trusts created by decedent Donations within 1 year prior to death