Name:

Telephone No.

I. Some Basics:

1. I have a living trust in effect.

2. I have made a will.

3. I am satisfied with my retirement income plan.

4. I am concerned about how estate taxes will be paid.

5. I would like to reduce the estate taxes that may arise on my death.

6. I have enough income if I become disabled.

7. I am the owner of an IRA.

8. I am a participant in a qualified retirement plan.

9. I would like to retire from work before I die.

10. During the last year, I have given very little thought to my estate plan.

11.  I have updated my will/living trust in the past three years.

12. I am an owner/partner/shareholder in a business.

* If your answer to question 12 is "Yes":

A.  On my death, others can carry on the business successfully.

B.  I can retire with financial independence.

13. I have a living trust but there are assets I own that are not yet held in trust title.

14. I have enough life insurance to meet my needs and those of my family as I see it.

II. Changes in Life:

15. I have had a significant, recent change in my net worth.

16. New children/grandchildren/spouse are in my family.

17. My health has changed in recent years.

18. I have made new investments.

19. My outlook toward my business associates has changed.

20. My investment priorities have changed.

21. The country of my citizenship or that of my spouse has changed.

III. Self Assessment

*** I could improve my estate planning by updating it.