Unmarried Couples Estate Planning Questionnaire
Personal Information
Partner 1 Full Name
Partner 2 Full Name
Partner 1 Date of Birth
Partner 2 Date of Birth
Partner 1 Address
Partner 2 Address
Partner 1 Phone
Partner 2 Phone
Partner 1 Email
Partner 2 Email
Children & Dependents
List names and birthdates of children or dependents
Assets
Real Estate (address, ownership, value)
Bank Accounts (institution, owner(s), type, balance)
Investments (type, owner(s), value)
Other Significant Assets
Liabilities
List debts (credit cards, loans, mortgages, etc.)
Beneficiaries
Primary Beneficiary(ies) names and relationships
Contingent Beneficiary(ies)
Health Care Directives
Who do you want to make health care decisions if you cannot?
Financial Power of Attorney
Who do you want to handle your finances if you are unable?
Funeral & Burial Wishes
Please specify any wishes
Additional Instructions or Notes