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WHEN YOU FORM YOUR COMPANY
OR TRUST ONLINE AT AMERILAWYER.COM,

PAYMENT IS NOT REQUIRED
COMPLEX LAST WILL & TESTAMENT INFORMATION SUMMARY AND INQUIRY TO SPIEGEL & UTRERA, P.A.
OUR GOAL—YOUR Complete Satisfaction and Understanding
Should you order this document from Spiegel & Utrera, P.A., Spiegel & Utrera, P.A., will incorporate your basic information into a draft document that will be conveyed to you for your review and make reasonable changes upon request.
Please complete where applicable
Name: *required
City:
State:
Telephone: *required
Cellular Phone:
Fax:
Email: *required
What do some of these terms mean? Click here for a Glossary.
Testator or Testatrix's Name:
Testator or Testatrix's Social Security Number:
Spouse of Testator or Testatrix
Spouse of Testator or Testatrix's Social Security Number:
Testator or Testatrix's Telephone Number:
Testator or Testatrix's Fax Number:
Testator or Testatrix's Email:
  
Testator or Testatrix's Address: 
Testator or Testatrix's Street:
Testator or Testatrix's City:
Testator or Testatrix's State:
Testator or Testatrix's Zip Code:
 
Testator or Testatrix's Mailing Address: 
Testator or Testatrix's Mailing Street:
Testator or Testatrix's Mailing City:
Testator or Testatrix's Mailing State:
Testator or Testatrix's Mailing Zip Code:

LAST WILL & TESTAMENT
Name of Last Will & Testament Personal Representative, Executor or Executrix:
Optional Address of Last Will & Testament Personal Representative, Executor or Executrix:
Last Will & Testament Personal Representative, Executor or Executrix's Relationship to Testator or Testatrix:
Last Will & Testament Personal Representative, Executor or Executrix's Telephone Number:
Special Instructions to Last Will & Testament Personal Representative, Executor or Executrix:
Name of Successor Last Will & Testament Personal Representative, Executor or Executrix:
Optional Address of Last Will & Testament Personal Representative, Executor or Executrix:
Successor Last Will & Testament Personal Representative, Executor or Executrix's Relationship to Testator or Testatrix:
Successor Last Will & Testament Personal Representative, Executor or Executrix's Telephone Number:
Special Instructions to Successor Last Will & Testament Personal Representative, Executor or Executrix:

Name of Beneficiary 1 of Last Will & Testament:
Optional Address of Beneficiary 1 of Last Will & Testament:
Beneficiary 1's Relationship to Testator or Testatrix:
Beneficiary 1's Percentage
 
Name of Beneficiary 2 of Last Will & Testament:
Optional Address of Beneficiary 2 of Last Will & Testament:
Beneficiary 2's Relationship to Testator or Testatrix:
Beneficiary 2's Percentage
 
Name of Beneficiary 3 of Last Will & Testament:
Optional Address of Beneficiary 3 of Last Will & Testament:
Beneficiary 3's Relationship to Testator or Testatrix:
Beneficiary 3's Percentage
 
Name of Beneficiary 4 of Last Will & Testament:
Optional Address of Beneficiary 4 of Last Will & Testament:
Beneficiary 4's Relationship to Testator or Testatrix:
Beneficiary 4's Percentage

ASSETS - Please indicate the assets held by the Testator or Testatrix below and describe as applicable
Residence/Home (Please provide a short description including the names(s) of the owner(s) that hold title, mortgage(s) (quantity and amount(s)), location (city and state), and approximate value).
Other Real Estate (Please provide a short description including the names(s) of the owner(s) that hold title, mortgage(s) (quantity and amount(s)), location (city and state), and approximate value).
Cash and cash equivalents (Please provide a short description including the name(s) of the account owner(s), location (city and state), and approximate value).
Investments
Life Insurance
IRA Accounts
Other Retirement Accounts
Notes, Mortgages and Obligations
Other Assets or Income
Other Property (car, boat, motorcycle, antiques)

Our Office

Miami

1840 Coral Way
4th Floor
Miami, FL 33145
Toll Free: (800) 603 - 3900
(305) 854-6000
Fax: (305) 857-3700
Natalia Utrera, Esq.,
Managing Attorney

New York City

1 Maiden Lane
5th Floor
New York, NY 10038
Toll Free: (800) 576-1100
(212) 962-1000
Fax: (212) 964-5600
Nicolas Spigner, Esq.
Managing Attorney

Clifton, NJ

642 Broad St., Suite 1B
Clifton, NJ 07013
Toll Free: (888) 336-8400
(973) 473-2000
Fax: (973) 778-2900
Sandy A. Adelstein
Managing Attorney

Los Angeles

8939 S Sepulveda Blvd.
Suite 400
Los Angeles, CA 90045
Toll Free: (888) 520-7800
(310) 258-9700
Fax: (310) 258-9400
Nicolas Spigner, Esq.
Managing Attorney

Delaware

9 East Loockerman Street
Suite 202
Dover, DE 19901
Toll Free: (888) 641-3800
(302) 744-9800
Fax: (302) 674-2100
Courtney Riordan, Esq.
Managing Attorney

Las Vegas

2545 Chandler Avenue
Suite 4
Las Vegas, NV 89120
Toll Free: (888) 530 4500
(702) 364 2200
Fax: (702) 458 2100
Joel S. Beck, Esq.
Managing Attorney

Chicago

Continental Office Plaza, Suite L12
2340 Des Plaines River Road
Des Plaines, IL 60018
Toll Free: (888) 514-9800
(312) 443-1500
Fax: (312) 443-8900
Michael C. Welchko, Esq.
Managing Attorney

General Counsel Club®

Unlimited Legal & Business Advice
LEARN MORE!
Toll Free: 1 (800) 734 - 9900
Fax: 1 (800) 520 - 7800
ClubAssist@AmeriLawyer.com
Natalia Utrera, Esq.,
Managing Attorney

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