Inheritance Advance Quotation Form

Your Name
Your Email Address
Contact Phone		Contact Fax
Beneficiary's Name

Estate Information Worksheet

Name of Deceased
Relationship to you		Date Of Death
Did the Deceased have a Will?	Yes No	Is there a Trust	Yes No
Any distributions to date?	Yes No	If "Yes", the dollar amount
Have you borrowed against your future inheritance?		Yes No
If "Yes", what is the amount		Est. Inheritance value
Advance amount request		Location of Estate (State)
Name Executor or Administrator
Executor / Administrator Email
Executor / Administrator Phone
Estate Attorney's Name
Estate Attorney's Email
Name of Law Firm
Why are you seeking this advance of funds against the estate?

Please answer the math question. The sum of 9 + 3 =

Estate Information Worksheet