Do you have any living children?

Yes     No

How many living children?

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 any deceased grandchildren?

Yes     No

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

Do you have a living parent?

Both    One     Neither

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 any deceased nieces or nephews?

Yes     No

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

Do you have any living grand-nieces or grand-nephews?

Yes     No

How many living grand-nieces and grand-nephews?

Do you have any deceased grand-nieces or grand-nephews?

Yes     No

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

Do you have any living grandparents?

Yes     No

How many living grandparents?

Any living aunts or uncles? (Do not include those who are related to you by marriage)

Yes     No

How many of these living aunts and uncles?

Any deceased aunts or uncles? (Do not include those related by marriage)

Yes     No

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

Any living first cousins?

Yes     No

How many living first cousins?

Do you have any deceased first cousins?

Yes     No

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

Any living first cousins once-removed?

Yes     No

How many living first cousins once-removed?

Any deceased first cousins once-removed?

Yes     No

How many of these deceased first cousins once-removed 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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