Inheritance EstateInterview Form |
KENNETH VERCAMMEN & ASSOCIATES, PC Please fill out completely and fax or mail back. This form is extremely important. Your accuracy and completeness in responding will help me best represent you. All sections and information must be filled out prior to sitting down with the attorney. PLEASE PRINT YOUR NAME _________________________________________________ ADDRESS ___________________________________________________ CITY ___________________________ STATE ____ ZIP _____________ CELL (____)____________________ TODAY'S DATE ____/_____/______ PHONE-DAY (____)________________ NIGHT (____)________________ E-MAIL ___________________________________________ Decedent’s Name ___________________________________ Date of Death (mm/dd/yy) ___ ___ /___ ___ /___ ___ ___ ___ Your relation to the person who passed away: _______________________ Referred By: ______________________________________ *All Pages and Information must be filled out prior to seeing the Attorney. This information is required by the Surrogate's Office and the Inheritance Tax Bureau. Date of Will? (mm/dd/yy) ___ ___ /___ ___ /___ ___ ___ ___ Location of original Will ____________________ Executor/ Administrator if not person filing out this form ____________ *The following questions are required by the Surrogate's Office and the Inheritance Tax Bureau to be answered. Please answer all these questions to the best of your knowledge so we can best help you. If none, write none. Decedent’s S.S. No. ___ ___ ___ /___ ___ /___ ___ ___ ___ County of Residence ________________________________ SCHEDULE “A” REAL PROPERTY If none, write none 1. Street and Number _____________________________________ Town: ____________________ Lot: ___ Block: ____ County: ____________________ Title/Owner of Record: _______________ Full Market Value of Property: $________ Mortgage Balance: $_________ Any other Real Estate: $______________________ SCHEDULE B-1: BANK ACCOUNTS/BROKERAGE ACCOUNTS BANK ACCOUNTS/BROKERAGE ACCOUNTS the Manner of Registration at Date of Death. If none, write none for each line. Use back of page if you need more space, or attach a list of assets. Bank Accounts - Individually or Jointly Owned Date of Death Value Name of Bank, Acct. # _____________ $_____________ ___________________________________________ $_____________ Stock INVESTMENT BONDS SCHEDULE B (1) - ALL OTHER PROPERTY ___________________________________________ $_____________ SCHEDULE “B” CLOSELY HELD “BUSINESSES” which the Decedent Held Any Interest, Market Value at Date of Death [attach details] If none, write none. ________________ $_____________ SCHEDULE “D” EXPENSES Probate Administration $ ____________________ Counsel Fees: $ ____________________ Executor’s or Administrator’s Commissions $ ____________________ Other Administration Expenses (list individually), attach receipts. SCHEDULE “E” BENEFICIARIES In case of Intestacy, the parentage of all collateral heirs (such as nieces, nephews, cousins, etc.) must be set forth. The relationship of step-parent, step-child, step-brother or step-sister must be so stated. BENEFICIARIES AND ADDRESSES or otherwise, in estate) HEIRS AT LAW/ __________________________________________________________ __________________________________________________________ __________________________________________________________ __________________________________________________________ __________________________________________________________
_________________________________________________________ (NOTE: LIST CHILDREN OF DECEASED NEXT OF KIN - /ALSO GIVE AGE OF ANY MINORS) 1. The Inheritance Tax Bureau will require certain documents. Please attach a photocopy (not original) of the decedent’s Will, Death Certificate, codicils, trusts, and last full year’s Federal Income Tax Return. This is required by the Surrogate's Office (Tax Bureau). We will also need photocopies of the Deed and Tax Bill to submit to the Inheritance Tax Bureau. SUMMARY Are any questions in Schedule “C” answered yes? Yes __ No ___ for estates over $2,000,000? Yes __ No ___ plus adjusted taxable gifts for Federal estate tax purposes under the provision of the Internal Revenue Code in effect on December 31, 2001 exceed $675,000? Yes __ No ___ If yes, by how much $ ___ ___ ___ How can we help you? What questions do you have? Is there anything else important: ______________________________________________________ ______________________________________________________ ______________________________________________________ ______________________________________________________ ______________________________________________________ New clients: When you come into the office would you like: updates in Probate, Traffic Law, and Personal Injury/ Insurance. Thank you. SCHEDULE “C” TRANSFERS BUREAU (DIVISION OF TAXATION) more, without receiving full financial consideration therefore? ___ Yes ___ No 2. Did decedent, at any time, transfer property, reserving (in whole or in part) the use, possession, income, or enjoyment of such property? ___ Yes ___ No 3. Did decedent, at any time, transfer property on terms requiring payment of income to decedent from a source other than such property? ___ Yes ___ No 4. Did decedent, at any time, transfer property, the beneficial enjoyment of which was subject to change because of a reserved power to alter, amend, or revoke, or which could revert to decedent under terms of transfer or by operation of law? ___ Yes ___ No transferred, the fair market value at date of death, dates of transfers, and to whom transferred. Submit copy of trust deed or, agreement, if any. (If transfers are claimed to be untaxable, also submit detailed statement of facts on which such claim is based, proof as to decedent’s physical condition and copy of death certificate.) 5. Was decedent a participant in any pension plan that provided for payment to another of an annuity or lump sum on or after death? ___ Yes ___ No 6. Did decedent purchase or in any manner participate in any contract or plan providing for payment of an annuity or lump sum on or after death to another, except life insurance contracts payable to a designated beneficiary? ___ Yes ___ No annuity contracts and refunds thereunder and interest income certificates even though issued by an insurance company are not considered life insurance contracts.) 7. Was a single premium life insurance policy issued on decedent’s life in conjunction with an annuity contract? ___ Yes ___ No plans, and policies. 8. Were any accumulated dividends due on any contract of insurance? (If yes, list below) ___ Yes ___ No For each transfer, set forth Date of Transfer; Description of Property, Both Real and Personal: Actual Consideration if Any; Names and Relationship to Decedent of Donees, Assignees, Transferees, etc. ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ Market Value at Date of Death __________________________ |
Wednesday, September 28, 2011
Inheritance Estate Interview Form
