James W. Martin, P.A.
                                
City Center, Suite 203N
100 Second Avenue South
St. Petersburg, Florida 33701
Tel (727) 821-0904
Fax (727) 823-3479
                                           
www.jamesmartinpa.com
jim@jamesmartinpa.com

 

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This Florida lawyer has written legal forms, books & articles for West, ALI-ABA & Fla. Bar Journal and is rated AV by Martindale-Hubbell. James W. Martin consults from his Saint Petersburg, Tampa Bay, Florida, law office on contract, business, corporate, probate, wills, trusts, real estate and lawsuit matters.

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FACT SHEET FOR MY HEIRS

Copyright 1988-2005 James W. Martin, Esq.

Note: This page is for background purposes only and is not intended as legal advice.


FACT SHEET FOR MY HEIRS

Date:

My full name at present:

My full name at birth:

My place of birth:

My date of birth:

Certified copy of my birth certificate or adoption certificate is located at:

My Social Security Number:

My present address:

My Professional advisors:

Name Address Telephone

Lawyer:

Accountant:

Dentist:

Physician(s):

Insurance agent(s):

Location of my Last Will and Testament and/or Living Trust and/or power of attorney:

My Last Will and/or Living Trust was signed on:

Location of my Living Will declaring my intention with regard to sustaining bodily functions through respiratory equipment, etc., in case of terminal illness:

 Year I became a resident of Florida:

My usual occupation:

My date of retirement:

U. S. citizen By: Birth Naturalization

Military veteran: Yes No

Branch of service:

Dates of service:

Serial Number:

Final rank:

Marital status: _______ Never married ______Married ________ Divorced _______Widowed

Spouse's name:

Date of marriage:

Name(s) of prior spouse(s):

Date(s) of divorce or death of spouse:

My Child(ren):

Name Address Date birth/death Married

My Grandchildren:

Name Address Date birth/death Married

My Parents:

Name Address Date of birth/death

My Brother(s) and sister(s):

Name Address Date birth/death Married

My Grandparents:

Name Address Date of birth/death

My Nephews/Nieces:

Name Address Date birth/death Married

My Educational background:

Name Location Dates Degrees Elementary:

Junior High School(s):

High School(s):

Vocational School(s):

College(s) and Graduate School(s):

My Employment:

Employer(s) Location Position Dates Type of Work

Organizations:

Residences: Address Dates

Religious preferences and memberships:

Funeral or memorial arrangements:

Name Address Telephone

I have a cemetery lot/crypt at:

I have made arrangements for donation of body parts with: (Note: Florida law requires that certain arrangements be made in order for this to be valid.)

Florida Driver's License No.: Expires:

Passport No.: Expires:

Florida Voter Identification No.:

Monthly income:

Amount Source

Salary:

Interest:

Rental income:

Dividends:

Social Security:

Pension:

Annuity:

Other:

Veteran's benefits: Claim No.:

Monthly bills and expenses: Amount To

Credit cards:

Company Address Card Number

Major loans, mortgages and debts I owe:

Insurance

Life insurance companies:

Agent and address:

Policy Nos.: Face Amount:

Beneficiary:

Type of life insurance:

Medical insurance company:

Agent and address: Policy No.:

Homeowner's and casualty insurance company:

Agent and address: Policy No.:

Automobile insurance:

Agent and address: Policy No.:

Banks and savings accounts:

Institution Account No. Type of Account Co-owner

Safe deposit box(es):

Institution Box No.

Stocks and bonds:

Broker:

Account No.:

Branch:

Telephone No.:

Securities: Issuer No.shares Date purchased Cost Value

Real estate:

Address Legal Description Co-owner(s) Market Value

Business(es):

Address Legal Description Co-owner(s) Market Value

I have a possible claim to sue:

Address:

Reason:

Amount:

I have a lawsuit pending against:

Reason:

My Attorney:

I have an uncollected judgment against:

Addresss:

My Attorney:

I am the beneficiary of a trust:

Description:

I expect to receive an inheritance from:

 

 


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DISCLAIMER
James W. Martin, P.A. appreciates your visiting its Web site. Please remember that this information is based on general facts and might not apply to specific factual situations. In addition, this information is based on Florida law, and the laws of other states may differ substantially. Please do not consider this information to be specific legal advice. Always consult a lawyer to apply the law to your specific facts and state.

Neither your sending email nor Mr. Martin's reading it creates an attorney-client relationship. Mr. Martin does not enter into an attorney-client relationship until he speaks to the client, checks for potential conflicts of interest, and issues an engagement letter.








 

 

FLORIDA BAR STATEMENT
The hiring of a lawyer is an important decision that should not be based solely upon advertisements. Before you decide, ask the lawyer to send you free written information about the lawyer's qualifications and experience.

 

 




Copyright 1998-2007 by James W. Martin, P.A. All rights reserved.

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