Estate Planning Form

Please use this questionnaire to list all of your assets, your best estimate of their values and who or how they are owned. Please also list all primary or secondary beneficiaries for those assets where a beneficiary designation is in place, i.e. life insurance, retirement accounts, IRA accounts, annuities, DOD or TOD accounts.

There is also some explanatory language regarding executors, trustees, trustee investment advisers, trustee removers, guardians for minor children and agents for property powers of attorney and health care powers of attorney.

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Bellatti, Fay, Bellatti & Beard, LLP
816 West State Street
Jacksonville, IL 62650

Phone: 217-408-0686
Fax: 217-245-2832
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