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Probate Inheritance Estate Interview
PLEASE FILL OUT ALL PAGES OF OUR CONFIDENTIAL INTERVIEW FORM
PLEASE PRINT

YOUR NAME _________________________________________________

ADDRESS ___________________________________________________

CITY ___________________________ STATE ____ ZIP _____________

CELL (____)_________________________

PHONE-DAY (____)________________ NIGHT (____)________________

E-MAIL ___________________________________________

Decedent¹s Name ___________________________________

Decedent¹s S.S. No. ___ ___ ___ /___ ___ /___ ___ ___ ___

Date of Death (mm/dd/yy) ___ ___ /___ ___ /___ ___ ___ ___

County of Residence ________________________________

Referred By: ______________________________________

Your relation to the person who passed away: _______________________

TODAY'S DATE ____/_____/__________

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) ___ ___ /___ ___ /___ ___ ___ ___
(If no will, write "no will")

Location of original Will ____________________
Indicate if Surrogate "Probate letters" were issued and where issued: __________

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.

SCHEDULE “A” REAL PROPERTY If none, write none

1. Street and Number _____________________________________

Town: ____________________

Lot: ___ Block: ____ County: ____________________

Title/Owner of Record: _______________

Tax Assessor Assessed Value: $____________________

Full Market Value of Property: $________ Mortgage Balance: $_________

Any other Real Estate: $______________________

SCHEDULE “B (1)” BANK ACCOUNTS, STOCK, CD, OTHER ASSETS
All Other Personal Property Owned Individually or Jointly; Market Value, Indicate the Manner of Registration at Date of Death. If none, write none for each line
Bank Account - Name of Bank, Acct. # _____________ $_____________

___________________________________________ $_____________
___________________________________________ $_____________
Stock - Name of Stock Co., Acct. # ________________ $_____________
___________________________________________ $_____________
Cars _______________________________________ $_____________
Other assets over $10,000 ______________________ $_____________
___________________________________________ $_____________
___________________________________________ $_____________
___________________________________________ $_____________


SCHEDULE “D” EXPENSES
Estimated Expenses for Funeral $ ____________________

Probate Administration $ ____________________

Counsel Fees: $ ____________________

Executor¹s or Administrator¹s Commissions $ ____________________

Other Administration Expenses (list individually), attach receipts.
Expense _________________ $ ____________________
Expense _________________ $ ____________________
Expense _________________ $ ____________________
Expense _________________ $ ____________________
Expense _________________ $ ____________________
Expense _________________ $ ____________________
Expense _________________ $ ____________________

INSTRUCTIONS FOR SCHEDULE “D” AS REQUIRED BY INHERITANCE TAX BUREAU. PERMITTED EXPENSES AT THE END OF THIS FORM.

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
(State full names and addresses of all who have an interest, vested, contingent or otherwise, in estate)

HEIRS AT LAW/
NEXT OF KIN: RELATIONSHIP: ADDRESS: APPROX. AGE: % INTEREST:

__________________________________________________________

__________________________________________________________

__________________________________________________________

__________________________________________________________

__________________________________________________________


Any specific bequests/gifts in will? _____________________________

_________________________________________________________

(NOTE: LIST CHILDREN OF DECEASED NEXT OF KIN - /ALSO GIVE AGE OF ANY MINORS)
State full names of all beneficiaries who died before or after decedent's death: ____________________________

1. Attach a photocopy (not original) of the decedent¹s Will, Death Certificate, codicils, trusts, and last full year¹s 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
1. Real Property - Schedule A $_______________
2. All Other Assets - Schedule B(1) $_______________
3. Closely Held “Businesses” - Schedule B $_______________
4. Transfers prior to death - Schedule C $_______________
5. Gross Estate . . Total Lines 1 thru 4 $_______________
6. Deductions/Expenses . . . - Schedule D $_______________
7. Net Estate . . Total - Line 5, minus Line 6 $_______________
8. Contingent Amount Included in Line 7 $_______________
9. Balance of Estate (Line 7, minus Line 8) $_______________

Are any questions in Schedule “C” answered yes? Yes __ No ___
Have or will you file or are you required to file a Federal Estate Tax Return for estates over $2,000,000? Yes __ No ___
Has or will any disclaimer been filed? If so, attach copy Yes __ No ___
If the decedent died after December 31, 2001, did the decedent¹s taxable estate 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:
Pen ___, Foam can holder ___, USA key chain ___, Calendar ___, T-Shirt _____?
All new clients are entitled to receive our Free Email Newsletter featuring updates in Probate, Traffic Law, and Personal Injury/ Insurance. Thank you.

SCHEDULE “B (2) CLOSELY HELD “BUSINESSES”
Proprietorship, Partnership, Joint Venture and/or Closely Held Corporation in which the Decedent Held Any Interest, Market Value at Date of Death [attach details]If none, write none.
____________________________________ $_____________

SCHEDULE “C” TRANSFERS
(THESE QUESTIONS ARE REQUIRED BY THE INHERITANCE TAX BUREAU (DIVISION OF TAXATION)
1. Did decedent, within three years of death, transfer property, valued at $500.00 or more, without receiving full financial consideration therefor? ___ 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
If answer to any of the above questions is “Yes”, set forth a description of property 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 decedent¹s 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
(Matured endowment policies, claim settlement certificates, supplementary contracts, 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 decedent¹s life in conjunction with an annuity contract? ___ Yes ___ No
If answer to questions 5, 6 or 7 is “Yes,” attach photostatic copies of all such contracts, 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 __________________________

SCHEDULE “D” EXPENSES

NOTE: No debt or claim is to be listed in this schedule unless still owing and unpaid at the time of death and unless such debt or claim is to be paid out of the assets of the estate.
(EXAMPLE: That portion of medical bills paid or reimbursed by Medicare or other medical insurance should not be claimed on this schedule).
Contested claims must be explained in detail. Do not list any taxes, either real, personal or income, chargeable for any period subsequent to date of death; nor any claim against property located outside of New Jersey, unless such property is subject to tax in this state.
List mortgages on Schedule “A”.

FUNERAL EXPENSES: ADMINISTRATION EXPENSES:
Cemetery Plot (immediate family) Appraisal of real estate
Funeral Luncheon Appraisal of personal effects
Flowers Surrogate¹s fees
Minister/Rabbi Probate expenses
Monument/Lettering Fee to notify creditors
Funeral Costs Death certificates
Acknowledgments Telephone tolls
Cost of Executor¹s or Administrator¹s Bond
Collection costs
Court costs
Cost on recovery and/or discovery of assets
Will contests
Realty commissions in accordance with N.J.A.C. 18:26-7.12
Probate litigation Storage of property if delivery to legatee not possible within reasonable time

DEBTS OF DECEDENT OWING and UNPAID AT TIME OF DEATH:
Personal accounts
Judgments
Federal income and gift taxes generally
Charitable pledges
State, county and local taxes accrued before death
Unpaid Inheritance Tax on interrelated estate

NON- DEDUCTIBLE EXPENSES
Contingent liabilities
Mortgage, taxes and accrued interest on tenants by entirety property
Debts paid by insurance
Medical expenses paid prior to death
Liabilities of corporation of which decedent was a shareholder
Real estate and property maintenance costs
Storage expense
Litigated and disputed claims
State, county and local taxes accruing after date of death
Transfer Inheritance Tax
Real estate brokers commissions, except if real property sold during administration of estate
Debts on property located outside of New Jersey
Federal Estate Tax