Do you have any living children?

Yes     No

How many living children do you have?

Do you have any deceased children?

Yes     No

How many of these deceased children have living children or grandchildren?

Do you have any living grandchildren?

Yes     No

How many living grandchildren do you have?

Do you have any deceased grandchildren?

Yes     No

How many of these deceased grandchildren have living children or grandchildren?

Is your present spouse the parent of all of your children? (Not including any deceased who do not have living children or grandchildren)

Yes     No

Is your present spouse the parent of all of your deceased children? (Only those with living children or grandchildren.)

Yes     No

Is your present spouse the parent of all of your living children?

Yes     No

Does your present spouse have any living children, grandchildren, or great-grandchildren by someone other than you?

Yes     No

Are either of your parents living?

Yes     No

Do you have any living siblings?

Yes     No

How many living siblings?

Do you have any deceased siblings?

Yes     No

How many of these deceased siblings have living children or grandchildren?

Do you have any living nieces or nephews?

Yes     No

How many living nieces and nephews do you have?

Do you have any deceased nieces or nephews?

Yes     No

How many of these deceased nieces and nephews have living children or grandchildren?

Are either of your maternal grandparents living?

Yes     No

Do you have any living maternal aunts or uncles? (Do not include those related by marriage)

Yes     No

How many of these living maternal aunts and uncles do you have?

Do you have any deceased maternal aunts or uncles? (Do not include those related by marriage)

Yes     No

How many of these deceased maternal aunts and uncles have living children or grandchildren?

Do you have any living maternal first cousins?

Yes     No

How many living maternal first cousins do you have?

Do you have any deceased maternal first cousins?

Yes     No

How many of these deceased maternal first cousins have living children or grandchildren?

Are either of your paternal grandparents living?

Yes     No

Do you have any living paternal aunts or uncles? (Do not include those related by marriage)

Yes     No

How many of these living paternal aunts and uncles do you have?

Do you have any deceased paternal aunts or uncles? (Do not include those related by marriage)

Yes     No

How many of these deceased paternal aunts and uncles have living children or grandchildren?

Do you have any living paternal first cousins?

Yes     No

How many living paternal first cousins do you have?

Do you have any deceased paternal first cousins?

Yes     No

How many of these deceased paternal first cousins have living children or grandchildren?

Without a Will, this estate will be distributed as follows:

* These are PRE-TAX shares, the sum of which will always equal the entered estate value.

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