Probate Questionnaire – Keith R. Lyman LLC

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1 Applicant Information

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About You: Please provide your information as the person applying to be appointed Personal Representative / Special Administrator of the estate.

Personal Representative / Applicant

First Name

Last Name

Date of Birth

SSN

Sex

Race

Height

Weight

Eye Color

Hair Color

Contact Information

Cell Phone

Home Phone

Work Phone

Physical Address

Street Address

City

State

ZIP

Mailing Address

Same as physical address

Licensed Fiduciary

Are you an Arizona Licensed Fiduciary?

Licensed Fiduciary Number

Relationship to Decedent

Your Relationship to the Decedent

Criminal History

Have you ever been convicted of a crime?

Please describe the conviction(s)

2 Decedent Information

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About the Deceased: Please provide information about the person who has passed away.

Decedent's First Name

Decedent's Last Name

Date of Birth

Date of Death

SSN

Street Address (Last Known)

City

State

ZIP

County of Residence at Death

3 Will Information

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Did the decedent leave a Will?

Date of Will

Does the Will waive bond?

Location of Original Will

4 Heirs of the Decedent

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Identifying Heirs: Heirs are determined by law. Please list the decedent's surviving descendants (children, grandchildren). If the decedent had no surviving descendants, list the decedent's living parents. If no surviving parents, list the decedent's siblings. Include full contact information for each person.

Heir Category

Which category of heirs applies?

Heirs

5 Will Beneficiaries

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Beneficiaries under the Will: List all persons or organizations who are entitled to receive anything under the decedent's Will. This may include people who are also heirs, as well as non-relatives, friends, charities, or other organizations.

6 Bond Waiver

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About Bond: A bond is a type of insurance that protects the estate. If there is no Will, or if the Will does not waive bond, the court typically requires a bond unless all heirs agree to waive it.

Will any of the heirs agree to waive bond?

Additional notes about bond

7 Decedent's Assets

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Estate Assets: Please list all assets owned by the decedent at the time of death. Provide as much detail as possible about each asset, including a description and estimated value.

Real Estate

Property Description / Address	Title Held As	Est. Value

Bank & Cash Accounts

Institution	Account Type	Approx. Balance

Investment & Brokerage Accounts

Institution	Account Type	Approx. Value

Retirement Accounts

Institution	Type (401k, IRA, etc.)	Beneficiary	Approx. Value

Life Insurance Policies

Company	Policy Type	Beneficiary	Death Benefit

Vehicles

Year / Make / Model	Title Held As	Est. Value

Personal Property & Other Assets

Description	Est. Value

Business Interests

Business Name	Entity Type	% Ownership	Est. Value

Known Debts & Liabilities

Creditor / Description	Approx. Amount Owed

8 Additional Information

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Is there anything else you think we should know about the estate or the circumstances?

9 Review & Submit

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Please review your answers above before submitting. You can click on any section header to expand and review your responses. Once submitted, our office will receive your information and contact you regarding next steps.

I certify under penalty of perjury that the information provided is true and correct to the best of my knowledge and belief.

Confidentiality Notice: The information you provide in this questionnaire is for the exclusive use of Keith R. Lyman LLC and is protected by attorney-client privilege. This form does not constitute legal advice and does not establish an attorney-client relationship until a formal engagement letter is signed.