INHERITANCE TRUST & PROBATE QUOTE SHEET

*REQUIRED

Name:*      Address:*

City:*       State:* Zip:*

County of Residence: *  

Day Phone:  ()          Evening Phone: ()

FAX Phone:  ()         Work Phone:    ()

Best time to call: A.M.    P.M.    Eastern    Pacific    Central

E-mail address:*    Social Security No.:

Name of Deceased:      Date of Death:

Name of Trust ( if any ):

Court:  County: Zip:

Docket / Case Number:

Name of Executor / Trustee:

Address:

City:      State:  Zip:

Day Phone:  ()          Evening Phone: ()

FAX Phone:  ()         Work Phone:    ()

Best time to call: A.M.    P.M.    Eastern    Pacific    Central

E-mail address:

Name of Estate Attorney:

Estate Attorney Law Firm Name:

Estate Attorney Mailing Address:

City:       State: Zip:

Estate Attorney Phone:   FAX:

Amount of expected distributions to applicant / heir in dollars:

Amount of money requested by applicant:

Has the applicant / heir received preliminary distributions?:    Yes       No

If "Yes" how much:

Has the applicant / heir already borrowed or assigned a portion of the inheritance:    Yes       No

If "Yes" how much:

Have you ever used a cash flow broker before?    Yes     No

Have you been shopping this deal?  If  yes, what is the highest bid you received?

Who gave this bid to you?

Search Engine------------Name of search engine:        

Keywords Used--------------

Banner Ad----Where did you see our banner?

Classified Ad---------Where did you see it? 

Newsgroup--------------Which newsgroup?

Other: -----