Page 1

1 of 1 DOCUMENT
California Legal Forms--Transaction Guide
Copyright 2011, Matthew Bender & Company, Inc., a member of the LexisNexis Group.
DIVISION IV: WILLS AND TRUSTS
CHAPTER 60 ESTATE PLANNING
PART IV. FORMS
23-60 California Legal Forms--Transaction Guide 60.200
60.200 Client Interview Checklist

[1] Comment
[a] Use of Form
This form is a checklist that an estate planning attorney may use to record estate planning information. It is designed to
be filled out by the attorney rather than the client and to suggest important questions that the attorney should ask the
client. Properly used, the form will help the attorney elicit all of the information necessary to begin the preparation of an
estate plan.
[b] Advantages and Disadvantages of Questionnaires
Different attorneys have different opinions about the use of estate planning questionnaires. Some routinely ask clients to
complete detailed questionnaires before (or shortly after) the first interview. They believe that the early completion of a
questionnaire will provide the attorney with the essential information at the earliest possible stage of the estate planning
process and reduce the likelihood that important facts will be overlooked. Other attorneys, however, use questionnaires
sparingly, if at all. These attorneys are concerned that questionnaires will annoy or intimidate many clients, and may
discourage some potential clients from availing themselves of the attorney's services.
Clients who have had no previous relationship with the attorney are most likely to respond negatively to questionnaires.
Attorneys who are reluctant to use questionnaires at or before the first interview will sometimes use a questionnaire
after they have personally spoken with a client, explained the purpose of the questionnaire, and satisfied themselves that
the client is not reluctant to commit personal information to a printed form.
Since this form is designed to be completed by the attorney rather than the client, it will minimize many of the concerns
associated with the use of questionnaires while helping to assure that the attorney obtains the essential estate planning
information.
[c] Need for Further Information

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23-60 California Legal Forms--Transaction Guide 60.200

This form is designed to elicit only the information that is necessary to initiate the estate planning process. As the
process continues, the specific needs and wishes of the client will become apparent and further information will be
required. The character of that further information will depend on the circumstances of each client.
[2] FORM
Client Interview Checklist
CLIENT INTERVIEW CHECKLIST
Name
Mr. ____________________Ms. ____________________Mrs.
____________________ Miss. ____________________Dr.
____________________Other ____________________.
Full name ___________________ [first, middle, last, and any additional designation, e.g., Jr. or III].
Any assumed or former names, such as maiden name or nickname, that
should be included in will or trust ___________________.
Residence
Street number ____________________.
City ____________________.
State ____________________.
Zip ____________________.
County ____________________.
Telephone number ____________________.
Citizenship
Country of citizenship ___________________.
Marital Status
Currently married ____________________Never married
____________________ Widowed ____________________ Marriage terminated by divorce or dissolution ____________________ Marriage terminated by annulment ____________________.
Spouse
If client is currently married, entering following information regarding spouse:
Mr. ____________________ Ms. ____________________ Mrs.
____________________ Miss. ____________________ Dr.
____________________ Other ____________________.
Full name of spouse ___________________ [first, middle, last, and
any additional designation, e.g., Jr. or III].
Any assumed or former names of spouse, such as maiden name or nickname, that should be included in will or trust ___________________.
Date and place of marriage ___________________.
Country of spouse's citizenship ___________________.
Do client and spouse currently reside at same address?
____________________.
If not, enter following information for spouse's residential address:

Page 3
23-60 California Legal Forms--Transaction Guide 60.200

Street number ____________________.

City ____________________.
State ____________________.
Zip ____________________.
County ____________________.
Telephone number ____________________.
Former Spouse(s)
Has client been married previously? ____________________.
If so, how many times? ____________________.
Enter following information regarding each former spouse:
First former spouse:
Name ___________________.
Date and place of marriage ___________________.
Length of marriage ___________________.
If marriage dissolved, court and date of dissolution
___________________.
If marriage annulled, court and date of annulment
___________________.
If spouse deceased, when deceased ___________________.
Second former spouse:
Name ___________________.
Date and place of marriage ___________________.
Length of marriage ___________________.
If marriage dissolved, court and date of dissolution
___________________.
If marriage annulled, court and date of annulment
___________________.
Third former spouse:
Name ___________________.
Date and place of marriage ___________________.
Length of marriage ___________________.
If marriage dissolved, court and date of dissolution
___________________.
If marriage annulled, court and date of annulment
___________________.
If spouse deceased, when deceased ___________________.
Current Domestic Partner
If client is unmarried, is client currently cohabiting with another
person? ____________________.
Approximately how long? ____________________.
Other person's name. ____________________.
Other person's date of birth. ____________________.

Page 4
23-60 California Legal Forms--Transaction Guide 60.200

Other person's current age. ____________________.

Have client and other person filed declaration of domestic partnership with California Secretary of State? ____________________.
If so, date declaration was filed: ____________________.
Has client previously filed any declarations of domestic partnership
with California Secretary of State? ____________________.
If so, how many times? ____________________.
Name of former domestic partner: ____________________.
Date on which declaration of domestic partnership was filed:
____________________.
Length of domestic partnership: ____________________.
Date when partnership terminated: ____________________.
Manner in which partnership was terminated (e.g., death or marriage
of partner; written notice; cessation of common residence):
____________________.
Was formal Notice of Termination filed with California Secretary of
State? ____________________.
If so, date notice was filed: ____________________.
Children
Number of living children ____________________.
Number of deceased children ____________________.
Number of adopted children ____________________.
Number of children by previous marriage(s) ____________________.
Living Children
If client has living child(ren), enter following information:
First
chil
d:
Nam
e
___
___
___
___
___
___
_.
Mal
e
___
___
___
___
___

Page 5
23-60 California Legal Forms--Transaction Guide 60.200

___
__
or
female
___
___
___
___
___
___
__.
Cou
ntry
of
chil
d's
citizenship
___
___
___
___
___
___
_.
Min
or
___
___
___
___
___
___
__
or
adul
t
___
___
___
___
___
___
__.
Natural
___

Page 6
23-60 California Legal Forms--Transaction Guide 60.200

___
___
___
___
___
__
or
adopted
___
___
___
___
___
___
__.
Date
and
plac
e of
chil
d's
birth
___
___
___
___
___
___
_.
Is
chil
d's
other
parent
client's
current
spou
se?
___
___
___
___
___

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23-60 California Legal Forms--Transaction Guide 60.200

___
__.
If
not,
nam
e of
chil
d's
other
parent
and
current
relationship
to
client
___
___
___
___
___
___
_.
Do
client
and
chil
d
currentl
y
resid
e at
sam
e addres
s?
___
___
___
___
___
___

Page 8
23-60 California Legal Forms--Transaction Guide 60.200

__.
If
not,
enter
following
inform
atio
n for
chil
d's
residen
tial
addres
s:
Street number ____________________.
City ____________________.
State ____________________.
Zip ____________________.
County ____________________.
Telephone number ____________________.
Seco
nd
chil
d:
Nam
e
___
___
___
___
___
___
_.
Mal
e
___
___
___
___
___
___
__

Page 9
23-60 California Legal Forms--Transaction Guide 60.200

or
female
___
___
___
___
___
___
__.
Cou
ntry
of
chil
d's
citizenship
___
___
___
___
___
___
_.
Min
or
___
___
___
___
___
___
__
or
adul
t
___
___
___
___
___
___
__.
Natural
___
___
___

Page 10
23-60 California Legal Forms--Transaction Guide 60.200

___
___
___
__
or
adopted
___
___
___
___
___
___
__.
Date
and
plac
e of
chil
d's
birth
___
___
___
___
___
___
_.
Is
chil
d's
other
parent
client's
current
spou
se?
___
___
___
___
___
___
__.

Page 11
23-60 California Legal Forms--Transaction Guide 60.200

If
not,
nam
e of
chil
d's
other
parent
and
current
relationship
to
client
___
___
___
___
___
___
_.
Do
client
and
chil
d
currentl
y
resid
e at
sam
e addres
s?
___
___
___
___
___
___
__.
If

Page 12
23-60 California Legal Forms--Transaction Guide 60.200

not,
enter
following
inform
atio
n for
chil
d's
residen
tial
addres
s:
Street number ____________________.
City ____________________.
State ____________________.
Zip ____________________.
County ____________________.
Telephone number ____________________.
Thir
d
chil
d:
Nam
e
___
___
___
___
___
___
_.
Mal
e
___
___
___
___
___
___
__or
female

Page 13
23-60 California Legal Forms--Transaction Guide 60.200

___
___
___
___
___
___
__.
Cou
ntry
of
chil
d's
citizenship
___
___
___
___
___
___
_.
Min
or
___
___
___
___
___
___
__or
adul
t
___
___
___
___
___
___
__.
Natural
___
___
___
___
___
___
__or

Page 14
23-60 California Legal Forms--Transaction Guide 60.200

adopted
___
___
___
___
___
___
__.
Date
and
plac
e of
chil
d's
birth
___
___
___
___
___
___
_.
Is
chil
d's
other
parent
client's
current
spou
se?
___
___
___
___
___
___
__.
If
not,
nam
e of
chil

Page 15
23-60 California Legal Forms--Transaction Guide 60.200

d's
other
parent
and
current
relationship
to
client
___
___
___
___
___
___
_.
Do
client
and
chil
d
currentl
y
resid
e at
sam
e addres
s?
___
___
___
___
___
___
__.
If
not,
enter
following

Page 16
23-60 California Legal Forms--Transaction Guide 60.200

inform
atio
n for
chil
d's
residen
tial
addres
s:
Street number ____________________.
City ____________________.
State ____________________.
Zip ____________________.
County ____________________.
Telephone number ____________________.
Four
th
chil
d:
Nam
e
___
___
___
___
___
___
_.
Mal
e
___
___
___
___
___
___
__or
female
___
___
___
___
___

Page 17
23-60 California Legal Forms--Transaction Guide 60.200

___
__.
Cou
ntry
of
chil
d's
citizenship
___
___
___
___
___
___
_.
Min
or
___
___
___
___
___
___
__or
adul
t
___
___
___
___
___
___
__.
Natural
___
___
___
___
___
___
__or
adopted
___
___

Page 18
23-60 California Legal Forms--Transaction Guide 60.200

___
___
___
___
__.
Date
and
plac
e of
chil
d's
birth
___
___
___
___
___
___
_.
Is
chil
d's
other
parent
client's
current
spou
se?
___
___
___
___
___
___
__.
If
not,
nam
e of
chil
d's
other
parent

Page 19
23-60 California Legal Forms--Transaction Guide 60.200

and
current
relationship
to
client
___
___
___
___
___
___
_.
Do
client
and
chil
d
currentl
y
resid
e at
sam
e addres
s?
___
___
___
___
___
___
__.
If
not,
enter
following
inform
atio
n for
chil

Page 20
23-60 California Legal Forms--Transaction Guide 60.200

d's
residen
tial
addres
s:
Street number ____________________.
City ____________________.
State ____________________.
Zip ____________________.
County ____________________.
Telephone number ____________________.
Deceas
ed
Chil
dren
If
client
has
deceas
ed
children
,
enter
following
inform
atio
n:
First
chil
d:
Nam
e
___
___
___
___
___
___

Page 21
23-60 California Legal Forms--Transaction Guide 60.200

_.
Mal
e
___
___
___
___
___
___
__or
female
___
___
___
___
___
___
__.
Natural
___
___
___
___
___
___
__or
adopted
___
___
___
___
___
___
__.
Date
and
plac
e of
deat
h
___
___
___
___
___

Page 22
23-60 California Legal Forms--Transaction Guide 60.200

___
_.
Seco
nd
chil
d:
Nam
e
___
___
___
___
___
___
_.
Mal
e
___
___
___
___
___
___
__or
female
___
___
___
___
___
___
__.
Natural
___
___
___
___
___
___
__or
adopted
___
___
___
___

Page 23
23-60 California Legal Forms--Transaction Guide 60.200

___
___
__.
Date
and
plac
e of
deat
h
___
___
___
___
___
___
_.
Issue
of
Deceas
ed
Chil
dren
If
client
has
issue
of
deceas
ed
children
,
enter
following
inform
atio
n:
First
issue:

Page 24
23-60 California Legal Forms--Transaction Guide 60.200

Nam
e
___
___
___
___
___
___
_.
Mal
e
___
___
___
___
___
___
__or
female
___
___
___
___
___
___
__.
Min
or
___
___
___
___
___
___
__or
adul
t
___
___
___
___
___
___
__.
Natural
___
___

Page 25
23-60 California Legal Forms--Transaction Guide 60.200

___
___
___
___
__or
adopted
___
___
___
___
___
___
__.
Nam
e of
deceas
ed
chil
d
(par
ent
of
issue)
___
___
___
___
___
___
_.
Nam
e of
other
parent
___
___
___
___
___
___
_.
Seco
nd

Page 26
23-60 California Legal Forms--Transaction Guide 60.200

issue:
Nam
e
___
___
___
___
___
___
_.
Mal
e
___
___
___
___
___
___
__or
female
___
___
___
___
___
___
__.
Min
or
___
___
___
___
___
___
__or
adul
t
___
___
___
___
___
___
__.
Natural

Page 27
23-60 California Legal Forms--Transaction Guide 60.200

___
___
___
___
___
___
__or
adopted
___
___
___
___
___
___
__.
Nam
e of
deceas
ed
chil
d
(par
ent
of
issue)
___
___
___
___
___
___
_.
Nam
e of
other
parent
___
___
___
___
___
___
_.

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23-60 California Legal Forms--Transaction Guide 60.200

Thir
d issue:
Nam
e
___
___
___
___
___
___
_.
Mal
e
___
___
___
___
___
___
__or
female
___
___
___
___
___
___
__.
Min
or
___
___
___
___
___
___
__or
adul
t
___
___
___
___
___
___
__.
Nat-

Page 29
23-60 California Legal Forms--Transaction Guide 60.200

ural
___
___
___
___
___
___
__or
adopted
___
___
___
___
___
___
__.
Nam
e of
deceas
ed
chil
d
(par
ent
of
issue)
___
___
___
___
___
___
_.
Nam
e of
other
parent
___
___
___
___
___
___

Page 30
23-60 California Legal Forms--Transaction Guide 60.200

_.
AttorneyinFact
Under
Durable
Pow
er(s)
of
Attorney
Person(
s)
who
m
client
wish
es to
nom
inate
as
attorneyinfact
under
durable
pow
er of
attorney
for
prop
erty
man
agemen
t:

Page 31
23-60 California Legal Forms--Transaction Guide 60.200

First
choi
ce:
Nam
e
___
___
___
___
___
___
_
Relationship
___
___
___
___
___
___
_.
Stre
et
addres
s
___
___
___
___
___
___
_.
City
and
state
___
___
___
___
___
___
_.
Seco
nd
choi

Page 32
23-60 California Legal Forms--Transaction Guide 60.200

ce:
Nam
e
___
___
___
___
___
___
_.
Relationship
___
___
___
___
___
___
_.
Stre
et
addres
s
___
___
___
___
___
___
_.
City
and
state
___
___
___
___
___
___
_.
Existing
Estate

Page 33
23-60 California Legal Forms--Transaction Guide 60.200

Plan
ning
Docume
nts
Will
?
___
___
___
___
___
___
__.
Date
d
___
___
___
___
___
___
_.
Revoca
ble
Trus
t?
___
___
___
___
___
___
__.
Date
d
___
___
___
___
___
___
_.
Funded?
___
___
___

Page 34
23-60 California Legal Forms--Transaction Guide 60.200

___
___
___
__.
Not
funded?
___
___
___
___
___
___
__.
Irrevoca
ble
Trus
t?
___
___
___
___
___
___
__.
Date
d
___
___
___
___
___
___
_.
Funded?
___
___
___
___
___
___
__.
Not
funded?
___
___
___

Page 35
23-60 California Legal Forms--Transaction Guide 60.200

___
___
___
__.
Individu
al
Retiremen
t
Accoun
t?
Accoun
t
Nu
mbe
r
___
___
___
___
___
___
__.
Beneficiary
___
___
___
___
___
___
_.
Retiremen
t
fund
?
___
___
___
___
___
___

Page 36
23-60 California Legal Forms--Transaction Guide 60.200

__.
Beneficiary
___
___
___
___
___
___
_.
Incom
e
Employ
ed?
___
___
___
___
___
___
__.
If
so,
nam
e of
employ
er
___
___
___
___
___
___
_.
How
long
?
___
___
___
___
___
___
_.
An-

Page 37
23-60 California Legal Forms--Transaction Guide 60.200

nual
salar
y
$__
___
___
___
___
___
___.
Retired
?
___
___
___
___
___
___
__.
Social
Security
benefits
$__
___
___
___
___
___
___.
Other
retiremen
t incom
e
$__
___
___
___
___
___
___.

Page 38
23-60 California Legal Forms--Transaction Guide 60.200

Investmen
t incom
e
$__
___
___
___
___
___
___.
Assets
Approx
imat
e
total
valu
e of
all
assets
$__
___
___
___
___
___
___.
Real
Prop
erty
If
client
own
s
real
prop
erty,
enter
following
inform

Page 39
23-60 California Legal Forms--Transaction Guide 60.200

atio
n:
First
prop
erty:
General
descrip
tion
___
___
___
___
___
___
_.
Locatio
n
___
___
___
___
___
___
_.
Nam
e(s)
on
title
___
___
___
___
___
___
_.
Estimated
valu
e
$__
___
___
___
___

Page 40
23-60 California Legal Forms--Transaction Guide 60.200

___
___.
Encum
bran
ces
or liens
$__
___
___
___
___
___
___.
Whe
n acquir
ed
___
___
___
___
___
___
_.
How
acquir
ed:
Purchase ____________________.
Inheritance ____________________.
Inter vivos gift ____________________.
Other (specify) ___________________.
Char
acter
of
assets
used
to
acquir
e
prop
erty
(sep

Page 41
23-60 California Legal Forms--Transaction Guide 60.200

arate
or
com
munity
prop
erty
of
parti
es):
___
___
___
___
___
___
__.
Basi
s
$__
___
___
___
___
___
___.
Char
acter
of
prop
erty:
Joint Tenancy ____________________.
Community ____________________.
Community with right of survivorship ____________________.
Separate ____________________.
Quasi-community ____________________.
Seco
nd
prop
erty:
General
descrip
tion
___
___

Page 42
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___
___
___
___
_.
Locatio
n
___
___
___
___
___
___
_.
Nam
e(s)
on
title
___
___
___
___
___
___
_.
Estimated
valu
e
$__
___
___
___
___
___
___.
Encum
bran
ces
or liens
$__
___
___
___
___

Page 43
23-60 California Legal Forms--Transaction Guide 60.200

___
___.
Whe
n acquir
ed
___
___
___
___
___
___
_.
How
acquir
ed:
Purchase ____________________.
Inheritance ____________________.
Inter vivos gift ____________________.
Other (specify) ___________________.
Char
acter
of
assets
used
to
acquir
e
prop
erty
(sep
arate
or
com
munity
prop
erty
of
parti
es):
___
___
___
___

Page 44
23-60 California Legal Forms--Transaction Guide 60.200

___
___
__.
Basi
s
$__
___
___
___
___
___
___.
Char
acter
of
prop
erty:
Joint Tenancy ____________________.
Community ____________________.
Community with right of survivorship ____________________.
Separate ____________________.
Quasi-community ____________________.
Thir
d
prop
erty:
General
descrip
tion
___
___
___
___
___
___
_.
Locatio
n
___
___
___
___
___
___

Page 45
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_.
Nam
e(s)
on
title
___
___
___
___
___
___
_.
Estimated
valu
e
$__
___
___
___
___
___
___.
Encum
bran
ces
or liens
$__
___
___
___
___
___
___.
Whe
n acquir
ed
___
___
___
___
___
___
_.

Page 46
23-60 California Legal Forms--Transaction Guide 60.200

How
acquir
ed:
Purchase ____________________.
Inheritance ____________________.
Inter vivos gift ____________________.
Other (specify) ___________________.
Char
acter
of
assets
used
to
acquir
e
prop
erty
(sep
arate
or
com
munity
prop
erty
of
parti
es):
___
___
___
___
___
___
__.
Basi
s
$__
___
___
___
___
___
___.
Char

Page 47
23-60 California Legal Forms--Transaction Guide 60.200

acter
of
prop
erty:
Joint Tenancy ___________________.
Community ____________________.
Community with right of survivorship ____________________.
Separate ____________________.
Quasi-community ____________________.
Tangibl
e
Personal
Prop
erty
Estimated
valu
e of
hous
ehol
d
furnitur
e
and
furnishi
ngs
$__
___
___
___
___
___
___.
Item
s of
special
valu
e?
___
___

Page 48
23-60 California Legal Forms--Transaction Guide 60.200

___
___
___
___
__.
If
so,
enter
following:
First
item
:
General
descrip
tion
___
___
___
___
___
___
_.
Locatio
n
___
___
___
___
___
___
_.
Nam
e(s)
on
title
___
___
___
___
___
___
_.
Es-

Page 49
23-60 California Legal Forms--Transaction Guide 60.200

timated
valu
e
$__
___
___
___
___
___
___.
Encum
bran
ces
or liens
$__
___
___
___
___
___
___.
Whe
n acquir
ed
___
___
___
___
___
___
__.
How
acquir
ed:
Purchase ____________________.
Inheritance ____________________.
Inter vivos gift ____________________.
Other (specify) ___________________.
Char
acter
of
as-

Page 50
23-60 California Legal Forms--Transaction Guide 60.200

sets
used
to
acquir
e
prop
erty
(sep
arate
or
com
munity
prop
erty
of
parti
es):
___
___
___
___
___
___
__.
Char
acter
of
prop
erty:
Joint Tenancy ____________________.
Community ____________________.
Community with right of survivorship ____________________.
Separate ____________________.
Quasi-community ____________________.
Seco
nd
item
:
General
descrip
tion
___
___

Page 51
23-60 California Legal Forms--Transaction Guide 60.200

___
___
___
___
_.
Locatio
n
___
___
___
___
___
___
_.
Nam
e(s)
on
title
___
___
___
___
___
___
_.
Estimated
valu
e
$__
___
___
___
___
___
___.
Encum
bran
ces
or liens
$__
___
___
___
___

Page 52
23-60 California Legal Forms--Transaction Guide 60.200

___
___.
Whe
n acquir
ed
___
___
___
___
___
___
__.
How
acquir
ed:
Purchase ____________________.
Inheritance ____________________.
Inter vivos gift ____________________.
Other (specify) ___________________.
Char
acter
of
assets
used
to
acquir
e
prop
erty
(sep
arate
or
com
munity
prop
erty
of
parti
es):
___
___
___
___

Page 53
23-60 California Legal Forms--Transaction Guide 60.200

___
___
__.
Char
acter
of
prop
erty:
Joint Tenancy ____________________.
Community ____________________.
Community with right of survivorship ____________________.
Separate ____________________.
Quasi-community ____________________.
Thir
d
item
:
General
descrip
tion
___
___
___
___
___
___
_.
Locatio
n
___
___
___
___
___
___
_.
Nam
e(s)
on
title
___
___
___
___

Page 54
23-60 California Legal Forms--Transaction Guide 60.200

___
___
_.
Estimated
valu
e
$__
___
___
___
___
___
___.
Encum
bran
ces
or liens
$__
___
___
___
___
___
___.
Whe
n acquir
ed
___
___
___
___
___
___
__.
How
acquir
ed:
Purchase ____________________.
Inheritance ____________________.
Inter vivos gift ____________________.
Other (specify) ___________________.

Page 55
23-60 California Legal Forms--Transaction Guide 60.200

Char
acter
of
assets
used
to
acquir
e
prop
erty
(sep
arate
or
com
munity
prop
erty
of
parti
es):
___
___
___
___
___
___
__.
Char
acter
of
prop
erty:
Joint Tenancy ____________________.
Community ____________________.
Community with right of survivorship ____________________.
Separate ____________________.
Quasi-community ____________________.
Mon
ey
on
Deposit
in
Ban
ks

Page 56
23-60 California Legal Forms--Transaction Guide 60.200

and
Other
Financial
Institutions
Doe
s client
have
mon
ey
on
deposit
in
bank
s or
other
financial
institutions
?
___
___
___
___
___
___
__.
If
so,
enter
following
inform
atio
n:

Page 57
23-60 California Legal Forms--Transaction Guide 60.200

First
accoun
t:
Balance
in
accoun
t
$__
___
___
___
___
___
___.
Nam
e(s)
on
title
___
___
___
___
___
___
_.
Payondeat
h
beneficiary
?
___
___
___
___
___
___
__.
If
so,
nam
e
___
___

Page 58
23-60 California Legal Forms--Transaction Guide 60.200

___
___
___
___
_.
Char
acter
of
prop
erty:
Joint Tenancy ____________________.
Community ____________________.
Separate ____________________.
Quasi-community ____________________.
Seco
nd
accoun
t:
Balance
in
accoun
t
$__
___
___
___
___
___
___.
Nam
e(s)
on
title
___
___
___
___
___
___
_.
Payondeat
h

Page 59
23-60 California Legal Forms--Transaction Guide 60.200

beneficiary
?
___
___
___
___
___
___
__.
If
so,
nam
e
___
___
___
___
___
___
_.
Char
acter
of
prop
erty:
Joint Tenancy ____________________.
Community ____________________.
Separate ____________________.
Quasi-community ____________________.
Thir
d accoun
t:
Balance
in
accoun
t
$__
___
___
___
___
___

Page 60
23-60 California Legal Forms--Transaction Guide 60.200

___.
Nam
e(s)
on
title
___
___
___
___
___
___
_.
Payondeat
h
beneficiary
?
___
___
___
___
___
___
__.
If
so,
nam
e
___
___
___
___
___
___
_.
Char
acter
of
prop
erty:
Joint Tenancy ____________________.
Community ____________________.
Separate ____________________.
Quasi-community ____________________.

Page 61
23-60 California Legal Forms--Transaction Guide 60.200

Mutual
Fun
ds
and
Bro
kerage
Accoun
ts
Doe
s client
have
mutual
fund
s or
brok
erag
e accoun
ts?
___
___
___
___
___
___
__.
If
so,
enter
following
inform
atio
n:
First
fund
/
accoun
t:
Estim-

Page 62
23-60 California Legal Forms--Transaction Guide 60.200

ated
total
valu
e
$__
___
___
___
___
___
___.
Nam
e(s)
on
title
___
___
___
___
___
___
_.
How
acquir
ed:
Purchase ____________________.
Inheritance ____________________.
Inter vivos gift ____________________.
Other (specify) ___________________.
Char
acter
of
assets
used
to
acquir
e
prop
erty
(sep
arate
or
com
munity

Page 63
23-60 California Legal Forms--Transaction Guide 60.200

prop
erty
of
parti
es):
___
___
___
___
___
___
__.
Char
acter
of
prop
erty:
Joint Tenancy ____________________.
Community ____________________.
Community with right of survivorship ____________________.
Separate ____________________.
Quasi-community ____________________.
Seco
nd
fund
/
accoun
t:
Estimated
total
valu
e
$__
___
___
___
___
___
___.
Nam
e(s)
on
title
___

Page 64
23-60 California Legal Forms--Transaction Guide 60.200

___
___
___
___
___
_.
How
acquir
ed:
Purchase ____________________.
Inheritance ____________________.
Inter vivos gift ____________________.
Other (specify) ___________________.
Char
acter
of
assets
used
to
acquir
e
prop
erty
(sep
arate
or
com
munity
prop
erty
of
parti
es):
___
___
___
___
___
___
__.
Char
acter
of
prop

Page 65
23-60 California Legal Forms--Transaction Guide 60.200

erty:
Joint Tenancy ____________________.
Community ____________________.
Community with right of survivorship ____________________.
Separate ____________________.
Quasi-community ____________________.
Thir
d
fund
/
accoun
t:
Estimated
total
valu
e
$__
___
___
___
___
___
___.
Nam
e(s)
on
title
___
___
___
___
___
___
_.
How
acquir
ed:
Purchase ____________________.
Inheritance ____________________.
Inter vivos gift ____________________.
Other (specify) ___________________.

Page 66
23-60 California Legal Forms--Transaction Guide 60.200

Char
acter
of
assets
used
to
acquir
e
prop
erty
(sep
arate
or
com
munity
prop
erty
of
parti
es):
___
___
___
___
___
___
__.
Char
acter
of
prop
erty:
Joint Tenancy ____________________.
Community ____________________.
Community with right of survivorship ____________________.
Separate ____________________.
Quasi-community ____________________.
Other
Assets
___
___
___

Page 67
23-60 California Legal Forms--Transaction Guide 60.200

___
___
__
___
___
___
___
___
__
___
___
___
___
___
__
___
___
___
___
___
__
Debt
s
and
Liabilities
Approx
imat
e
total
of
all
debt
s
and
liabilities
$__
___
___
___
___
___
___.
Se-

Page 68
23-60 California Legal Forms--Transaction Guide 60.200

cure
d
Debt
s
and
Liabilities
First
debt
/
liability:
Descrip
tion
of
obligation
___
___
___
___
___
___
__.
Approx
imat
e
principal
amo
unt
$__
___
___
___
___
___
___.
Interes
t
rate
___
___
___

Page 69
23-60 California Legal Forms--Transaction Guide 60.200

___
___
___
_.
Paymen
ts of
$__
___
___
___
___
___
___
per
___
___
___
___
___
___
__.
Descrip
tion
of
security
___
___
___
___
___
___
_.
Seco
nd
debt
/
liability:
Descrip
tion
of
obligation

Page 70
23-60 California Legal Forms--Transaction Guide 60.200

___
___
___
___
___
___
__.
Approx
imat
e
principal
amo
unt
$__
___
___
___
___
___
___.
Interes
t
rate
___
___
___
___
___
___
_.
Paymen
ts of
$__
___
___
___
___
___
___
per
___
___
___
___
___

Page 71
23-60 California Legal Forms--Transaction Guide 60.200

___
__.
Descrip
tion
of
security
___
___
___
___
___
___
_.
Thir
d
debt
/
liability:
Descrip
tion
of
obligation
___
___
___
___
___
___
__.
Approx
imat
e
principal
amo
unt
$__
___
___
___
___

Page 72
23-60 California Legal Forms--Transaction Guide 60.200

___
___.
Interes
t
rate
___
___
___
___
___
___
_.
Paymen
ts of
$__
___
___
___
___
___
___
per
___
___
___
___
___
___
__.
Descrip
tion
of
security
___
___
___
___
___
___
_.
Unsecure
d

Page 73
23-60 California Legal Forms--Transaction Guide 60.200

Debt
s
and
Liabilities
First
debt
/
liability:
Descrip
tion
of
obligation
___
___
___
___
___
___
__.
Approx
imat
e
principal
amo
unt
$__
___
___
___
___
___
___.
Interes
t
rate
___
___
___
___
___

Page 74
23-60 California Legal Forms--Transaction Guide 60.200

___
_.
Paymen
ts of
$__
___
___
___
___
___
___
per
___
___
___
___
___
___
__.
Descrip
tion
of
security
___
___
___
___
___
___
_.
Seco
nd
debt
/
liability:
Descrip
tion
of
obligation
___
___

Page 75
23-60 California Legal Forms--Transaction Guide 60.200

___
___
___
___
__.
Approx
imat
e
principal
amo
unt
$__
___
___
___
___
___
___.
Interes
t
rate
___
___
___
___
___
___
_.
Paymen
ts of
$__
___
___
___
___
___
___
per
___
___
___
___
___
___
__.

Page 76
23-60 California Legal Forms--Transaction Guide 60.200

Descrip
tion
of
security
___
___
___
___
___
___
_.
Thir
d
debt
/
liability:
Descrip
tion
of
obligation
___
___
___
___
___
___
__.
Approx
imat
e
principal
amo
unt
$__
___
___
___
___
___
___.

Page 77
23-60 California Legal Forms--Transaction Guide 60.200

Interes
t
rate
___
___
___
___
___
___
_.
Paymen
ts of
$__
___
___
___
___
___
___
per
___
___
___
___
___
___
__.
Descrip
tion
of
security
___
___
___
___
___
___
_.
Legal Topics:
For related research and practice materials, see the following legal topics:
Estate, Gift & Trust LawGeneral Overview

102N96
********** Print Completed **********
Time of Request: Friday, May 20, 2011
Print Number:
2862:286771486
Number of Lines: 523
Number of Pages: 77

Send To:

YI, JAMES
MIAMI UNIVERSITY OF
1311 MILLER DRIVE
CORAL GABLES, FL 33124-8087

17:14:34 EST