Mark W.
Buckwalter*
mark@buckwalterlawfirm.com
Chase Giacomo
chase@buckwalterlawfirm.com
Joanna Galbraith
joanna@buckwalterlawfirm.com
Laura J. Webb**
laura@buckwalterlawfirm.com
40 2nd St. E., Ste. 222
*Licensed in Montana and Idaho
Kalispell, MT 59901
**Licensed in Montana Washington
Phone: (406) 314-6444
and California
Fax: (406) 890-6705
PROBATE QUESTIONNAIRE
Please complete this form and return to Buckwalter Law Firm, PLLC
hailey@buckwalterlawfirm.com
Your full legal name: ___________________________________________________________
Your relationship to the Decedent: _________________________________________________
Decedent’s legal name: __________________________________________________________
Decedent’s date of birth: _________________________________________________________
Decedent’s date of death: ___________________________________________ Age: ________
Decedent’s Social Security Number: ________________________________________________
Has a Probate already been opened for the Decedent? _____ Yes _____ No
Is there a conflict between any of the Heirs? _____ Yes _____ No
Is it a small estate (<$50k)? _____ Yes _____ No
If “No“ what is the approximate value of the Estate: _____________________________
Are you a Personal Representative of the Decedent? _____ Yes _____ No
If “No” who is the Personal Representative: ____________________________________
Did the Decedent have a Will and/or Trust? _____ Yes _____ No
If “Yes,” what is the name of the Trust? _______________________________________
If “Yes,” what is the date of the Will? _________________________________________
Did the Decedent have a Codicil to his/her Will? _____ Yes _____ No
If “Yes,” what is the date of the Codicil(s) to his/her Will: _________________________
Is there a conflicting Will? _____ Yes _____ No
Is there a claim of duress or undue influence? _____ Yes _____ No
If “ Yes” Elaborate:
Page 2
If the Decedent had a Will, please provide the name, address and telephone number of the
individual(s) nominated to act as Executor/Personal Representative:
Name of Personal Representative
Address:
Telephone Number:
Email address:
Social Security Number:
Name of Co-Personal Representative (if any)
Address:
Telephone Number:
Email address:
Social Security Number:
Please list the name, address, and relationship of the Decedent’s spouse (if married), children,
and any beneficiaries named in Decedent’s Will (if the Decedent had a Will). If any person is
under the age of 18, please list their age.
Name Address and email Relationship (i.e., spouse,
address, if available child)
and Age, if under 18 years
Please list all KNOWN creditors of the Decedent, including those in the following
categories:
Creditor Address Amount due
Mortgage(s)
Page 3
Other Secured Loans Address Amount due
Car Loans
Credit Cards
Medical Bills
Medicaid (payments by the Montana
Department of Public Health & Human
Services (DPHHS) for nursing home or other
care)
Taxes (real estate, state, federal, other)
Funeral /Burial Expenses (if these were paid
by a family member, please note)
Other Creditors/Debts
Page 4
Please list all assets owned by the Decedent at his/her death, including the following:
Asset Value Lien /Loan Beneficiary
Against named, if any
Asset
Real Property
1.
2.
3.
4.
Vehicles
1.
2.
3.
4.
Bank /Investment/Retirement
Accounts & Account Number
1. Checking Account
2. Savings Account
Page 5
Asset Value Lien /Loan Beneficiary
Against named, if any
Asset
3. Investment/Brokerage, Accounts
and/or Individual Shares of Stock
4. Retirement/Pension Accounts
5. Jewelry, Personal Property (just
provide an approximate fair market
value, unless there are specific items
with significant value which can be
listed individually)
