Domestic Partnership Agreement, Shared Property (Simple)

Selected clauses forDomestic Partnership Agreement, Shared Property (Simple)
for info, go to http://www.njlaws.com/Domestic_Partnership_Agreement_Shared_Property_Simple.htm

We, __________________________ and _________________________, make the following agreement:

1. We enter into this contract to set forth our rights and responsibilities to each other.

2. We intend to abide by the provisions of this agreement in the spirit of love, joy, cooperation, and good faith. [Specify the consideration for the contract].

3. We agree that all property owned by either of us, as of the date of this agreement, shall be considered to be and shall remain the separate property of each. Neither of us will have any claim to the separate property of the other absent a written agreement transferring ownership. A list of our major items of separate property are attached and incorporated into this agreement.

4. Our individual income, earned while we are living together and during this relationship, shall belong to both of us in equal shares. Likewise, all property accumulated from that income shall belong to both of us in equal shares. In the event we separate and/or terminate this domestic partnership we agree to divide all such accumulated property, in whatever form, equally between us.

5. We agree to maintain joint bank accounts. This includes checking and savings accounts. In the event we decide to obtain a joint credit card account we agree to be jointly liable for the credit card balance.

6. Neither party shall be responsible or liable for any credit card debt incurred by the other on his/her individual credit card accounts.

7. Neither of us shall be liable or responsible for the debts incurred by the other as an individual.

8. We agree to be jointly responsible for all joint debts and expenses.

9. We agree to equally divide all household and living expenses. This includes, but is not limited to, groceries, utilities, rent, and daily household expenses.

10. We also agree that we may, at some time, agree to own real property jointly. Any jointly held real property ownership shall be reflected either in writing or on the title to said property. In the event we dissolve our domestic partnership, we provide that any jointly held property will be divided into equal shares, unless we provide otherwise in a written document.

11. Any property received by one of us through gift or inheritance remains the separate property of the recipient. The other party has no claim on that separate property unless provided for in a written instrument.

12. Neither of us has any rights to, nor any financial interest in, any separate real estate owned entirely or partially by the other person. This includes any real property accumulated before or during our relationship.

13. We agree that either party can terminate this contract by giving the other party a one-week written notice of that intent. If either of us seriously considers leaving the relationship we both agree to at least three counseling sessions with a professional counselor or therapist.

14. In the event that this relationship is terminated we agree to divide all jointly held property equally. Neither of us shall have any claim against the other for support, property, or financial assistance.

15. We agree to resolve any dispute arising from this agreement through mediation. The mediator shall be an objective third party who is mutually agreed upon. The mediator’s role shall be to help us dissolve our relationship and resolve any differences concerning a division of jointly held property or other issues in a mature and unemotional manner. We agree to enter into mediation in good faith.

16. In the event that our attempt at good-faith mediation is unsuccessful to resolve all issues in dispute, either party may seek to resolve the issues through arbitration through the use of the following protocol:

a. Deliver a written demand for arbitration to the other person and name one arbitrator;

b. The other party shall respond with the name of a second arbitrator within five days from receipt of the notice;

c. The two named arbitrators shall select and name a third arbitrator;

d. The arbitration meeting will take place within seven days following the selection of the third arbitrator;

e. Each party is entitled to retain legal counsel at his/her own expense;

f. Each party may present witnesses and evidence at the arbitration hearing;

g. The arbitrators shall issue their decision within five days after the hearing. Their decision shall set forth their findings and conclusion and shall be in writing. The decision shall be binding upon each of us. We agree that neither party shall seek relief from the arbitration decision in court.

h. If the person to whom an arbitration demand is made fails to respond within five days, the other party may give an additional five days’ written notice of his/her intent to proceed. If there is still no response, the person initiating the arbitration may proceed with the arbitration before an arbitrator he/she has designated. Any award shall have the same force and effect as if all three arbitrators had settled it.

17. This agreement represents our complete understanding concerning our domestic partnership. It replaces any and all prior agreements, written or oral. We agree that this document can be amended only in writing and must be signed by both of us.

18. We acknowledge that both of us have had the opportunity to consult with an attorney of our choice to review this document. We also acknowledge that each of us, as individuals, is responsible for consulting with an attorney. The failure or refusal of either or both of us to do so shall not be construed to mean this Domestic Partnership Agreement was not entered into willingly, freely, and voluntarily by both of us.

19. We agree that in the event a court finds any portion of this contract to be illegal or otherwise unenforceable, the remainder of the contract shall remain in full force and effect.

Signed this _____ day of ______________, 20__, at _____________________, _______________.
__________________________________ ______________________________

Signature Signature

State of ___________________

County of _________________

______________________ and _____________________________, personally appeared before me and executed and acknowledged this Domestic Partnership Agreement before me this ____ day of ____________, 20__.

_____________________________________

Notary Public

Exhibit A: Separate Property of ____________________________________________

Exhibit B: Separate Property of ____________________________________________

Exhibit C: Jointly Held Property of _________________ and ___________________

WILLS, PROBATE AND ELDER LAW- Estate Planning for Same Sex couples

WILLS, PROBATE AND ELDER LAW- Adult and Community Education
WHEN: Tuesday October 21, 2008 7 - 9 P.M.

East Brunswick Adult & Community Education Program
East Brunswick HIGH SCHOOL, Cranbury Rd
Course # FBB ...............................................................Fee: $29

Instructor: Kenneth Vercammen, Esq. of Edison
(Co-Author- NJ Elder Law & Probate)
COMPLIMENTARY MATERIAL: Brochures on Wills, “Probate and Administration of an Estate”, Power of Attorney, Living Wills, Real Estate Sales for Seniors, and Trusts.

You don’t have to be wealthy or near death to do some thinking about a will. Here is your opportunity to listen to an experienced attorney who will discuss how to distribute your property as you wish and avoid many rigid provisions of the state law. Topics covered by author of “Answer to questions about Probate” will include: Wills, revocable trusts, irrevocable trusts, power of attorney, living will, long term care insurance, reverse mortgage, plus the opportunity to ask questions.
Here is your opportunity to listen to an experienced attorney who will answer questions how to distribute your property and avoid many rigid provisions of state law. For more information on Elder law, visit the Website www.centraljerseyelderlaw.com. You can also subscribe to the free email Elder Law newsletter by visiting the website, or sending an email to Kenv@njlaws.com.
Tues. 7:00–8:30 pm .......................................1 session: 10/21

Call the Adult Education Office for registration information 732- 613-6989
http://www.ebnet.org/Community_Programs/downloads/Fall_2008_Web.pdf
Please make checks payable to Adult and Community Education and mail to: Director, East Brunswick Adult and Community Education, EBHS, 380 Cranbury Road, East Brunswick, NJ 08816-3095.
About the Speaker: Kenneth Vercammen is an Elder Law and Litigation Attorney in Edison, NJ. He often lectures for the American Bar Association and New Jersey State Bar Association on Elder Law, personal injury, and criminal / municipal court matters. He has published 125 articles in national and New Jersey publications on legal topics. He speaks as a volunteer on Wills and Elder law to Adult Community Schools and non profit groups including Edison, Metuchen, Woodbridge, East Brunswick, North Brunswick, South Brunswick, Piscataway, Sayreville, Old Bridge, Spotswood and Perth Amboy Seniors. He has established New Jersey’s most popular Elder law website on the Internet to provide information on Probate, Elder Law and Traffic matters located at www.centraljerseyelderlaw.com.
East Brunswick Wills rev 9/30/08Macbook

Domestic Partnership Agreement, Separate Property (Simple)

Domestic Partnership Agreement, Separate Property (Simple)

We, __________________________ and _________________________, make the following agreement:
1. We enter into this contract to set forth our rights and responsibilities to each other. [Recite the consideration for the contract.]
2. We intend to abide by the provisions of this agreement in the spirit of love, joy, cooperation, and good faith.
3. We agree that all property owned by either of us, as of the date of this agreement, shall be considered to be and shall remain the separate property of each. Neither of us will have any claim to the separate property of the other absent a written agreement transferring ownership. Lists of our major items of separate property are attached and incorporated into this agreement.
4. Our individual income and any property accumulated from that income shall remain the separate property of the person earning the income. Neither of us shall have any claim to this separate property.
5. Each of us shall maintain separate bank accounts. This includes checking, savings, and credit card accounts.
6. Neither of us shall be liable or responsible for the individual debts incurred by the other in her/his own name.
7. We agree to be jointly responsible for all debts we enter into together.
8. We agree to equally divide all household and living expenses. This includes, but is not limited to, groceries, utilities, rent, and daily household expenses.
9. We agree that there may be a need to maintain a joint bank account (checking or savings) for a specific purpose. In that event, we agree to contribute an equal amount to the bank account. Neither party will have the right to withdraw funds from that account without the permission and consent of the other.
10. We also agree that we may, at some time, agree to own property jointly. Any jointly held property ownership shall be reflected either in writing or on the title to said property. In the event we dissolve our domestic partnership, we provide that any jointly held property will be divided into equal shares, unless we provide otherwise in a written document.
11. Any property received by one of us through gift or inheritance remains the separate property of the recipient. The other party has no claim on that separate property unless provided for in a written instrument.
12. Neither of us has any rights to, nor any financial interest in, any real estate owned entirely or partially by the other person. This includes any real property accumulated before or during our relationship.
13. We agree that either party can terminate this contract by giving the other party a one-week written notice of that intent. If either of us seriously considers leaving the relationship we both agree to at least three counseling sessions with a professional counselor or therapist.
14. In the event that this relationship is terminated we agree to divide all jointly held property equally. Neither of us shall have any claim against the other for support, property, or financial assistance.
15. We agree to resolve any dispute arising from this agreement through mediation. The mediator shall be an objective third party who is mutually agreed upon. The mediator’s role shall be to help us dissolve our relationship and resolve any differences concerning a division of jointly held property or other issues in a mature and unemotional manner. We agree to enter into mediation in good faith.
16. In the event that our attempt at good-faith mediation is unsuccessful to resolve all issues in dispute, either party may seek to resolve the issues through arbitration through the use of the following protocol:
a. Deliver a written demand for arbitration to the other person and name one arbitrator;
b. The other party shall respond with the name of a second arbitrator within five days from receipt of the notice;
c. The two named arbitrators shall select and name a third arbitrator;
d. The arbitration meeting will take place within seven days following the selection of the third arbitrator;
e. Each party is entitled to retain legal counsel at his/her own expense;
f. Each party may present witnesses and evidence at the arbitration hearing;
g. The arbitrators shall issue their decision within five days after the hearing. Their decision shall set forth their findings and conclusion and shall be in writing. The decision shall be binding upon each of us. We agree that neither party shall seek relief from the arbitration decision in court.
h. If the person to whom an arbitration demand is made fails to respond within five days, the other party may give an additional five days’ written notice of his/her intent to proceed. If there is still no response, the person initiating the arbitration may proceed with the arbitration before an arbitrator he/she has designated. Any award shall have the same force and effect as if all three arbitrators had settled it.
17. This agreement represents our complete understanding concerning our domestic partnership. It replaces any and all prior agreements, written or oral. We agree that this document can be amended in only writing and must be signed by both of us.
18. We agree that in the event a court finds any portion of this contract to be illegal or otherwise unenforceable, the remainder of the contract shall remain in full force and effect.
Signed this _____ day of ______________, 20__, at _____________________,
_______________.
__________________________________ ______________________________
Signature Signature

State of ___________________
County of _________________
______________________ and _____________________________ personally appeared before me and executed and acknowledged this Domestic Partnership Agreement before me this ____ day of ____________, 20__.

_____________________________________
Notary Public

Exhibit A: Separate Property of ____________________________________________
Exhibit B: Separate Property of ____________________________________________

Domestic Partnership Agreement

Domestic Partnership Agreement (Complex)

AGREEMENT, made this _____ day of _________, 20__, between _______________, residing at

______________________ [hereinafter referred to as “_____________”], and ________________, residing at

_______________________ [hereinafter referred to as “______________”].

WHEREAS, the parties intend to establish a domestic partnership and raise children together, and desire to set forth their agreements and expectations regarding their financial, property, and other rights and obligations arising out of the contemplated domestic partnership; and,

WHEREAS, by execution of this Agreement, the parties hereby revoke and nullify any and all written agreements previously executed by either or both parties; this Domestic Partnership Agreement supersedes any and all previously executed or unexecuted Domestic Partnership Agreements between the parties;

NOW, THEREFORE, in consideration of the mutual promises and agreements herein contained, the parties hereto agree as follows:

1. Separate Property of Each Party
The parties wish to identify what will remain the separate property of each party during the domestic partnership, and to determine their rights in the event of a separation or dissolution of their domestic partnership, as hereinafter discussed.
The following shall constitute and remain the “separate property” of the respective parties: (a) property, whether real or personal, and whether vested, contingent, or inchoate, belonging to or acquired by a party prior to the contemplated domestic partnership of the parties, including without limitation the property listed on Schedules A-1 and A-2; (b) all property acquired by a party at any time by bequest, devise, inheritance, distribution from a trust, or by gift; (c) salary, wages, and other compensation for personal services; (d) retirement and pension benefits; (e) compensation for personal injuries; (f) proceeds of insurance policies received from any sources; (g) the increase in value of such property, whether or not such increase in value is due in whole or in part to the contributions or efforts of the other party; (h) rents, issues, profits, dividends, interest, or other income derived from other distributions upon such property; (i) the proceeds of the sale of such property; (j) property acquired in exchange for such property or acquired with the proceeds of the sale of such property; (k) any other property identified or defined as separate property elsewhere in this Agreement; and (l) any assets or property acquired at any time by either party in their singular name or jointly with another person. It is the agreement of the parties that unless property is denoted in this Agreement as joint property, it shall be considered separate property. Except as otherwise expressly provided in this Agreement, or by way of an addendum to this Agreement, each party shall be responsible for his/her own debts, unless a debt was undertaken in a joint manner, as evidenced by the documents creating such debt. Each party hereby indemnifies and holds harmless the other for any debt incurred by the party that is not a joint debt.

Except as otherwise expressly provided in this Agreement, each party shall keep and retain sole ownership, enjoyment, control, and power of disposal of his/her separate property of every kind and nature, now owned or hereafter acquired by such party, free and clear of any interest, rights, or claims of the other party by reason of the domestic partnership or otherwise. These rights include the right to dispose of his/her separate property by gift, sale, testamentary transfer, or in any other manner, and to encumber, pledge, or hypothecate such property.

Each party covenants and agrees not to make any claim or demand on the separate property of the other party or on the heirs, legal representatives, executors, or administrators of the other party with respect to the separate property of the other party, except as otherwise may be expressly provided in this Agreement.

If the parties commingled their separate property to acquire new property, the interests of the parties in this new property shall be separate property interests in proportion to their original contributions to the acquisition of such property.

Except as otherwise expressly provided in this Agreement, the separate property now or hereafter owned by one party can become joint or the property of the other party only by a written instrument reclassifying the property for purposes of this Agreement executed by the party whose separate property is thereby reclassified. No acts, conduct, or statements by either party shall change the status of separate property, other than an instrument executed by the party whose separate property is thereby reclassified.

No contribution by either party to the care, maintenance, improvement, custody, or repair of the separate property of the other party, whether such contributions are in the form of money, property, or personal services rendered, shall in any way alter or convert any of such separate property, or any increase in the value thereof, to the status of joint property. Any contributions by either party to the care, maintenance, improvement, custody, or repair of the separate property of the other party shall become part of the separate property of the other party, and the contributing party shall not have any claim for reimbursement. No use by either party of earnings or other separate property for joint or household expenses shall be construed to imply joint ownership of such assets.

Each party agrees, upon request, to cooperate with the other in connection with procuring loans secured by the other party’s separate property, including the execution of instruments waiving all rights with respect to the other’s separate property. The party owning the separate property shall indemnify and hold the party requested to execute such instruments harmless from and against any liability with respect thereto. Any proceeds derived from loans secured by a party’s separate property shall be said party’s separate property.

2. Joint Property
The parties recognize that they may from time to time acquire property in their joint names. This may include, for example, sums deposited into bank accounts in their joint names and stock and bond portfolios, certificates of deposit, and money market funds in their joint names.

Title to any and all savings accounts, certificates of deposit, money market certificates, cash reserve accounts, money management accounts, stocks, bonds, savings plans, securities, or any other funds or assets of the same or a similar nature (other than joint checking accounts) acquired jointly by both of the parties during the domestic partnership shall be placed in the names of both parties hereto in such manner that such assets may not be withdrawn or disposed of without the signatures of both parties thereto.

3. Gifts
All gifts given to the parties jointly shall be the joint property of the parties. Any gifts given from one party to the other prior to or during the domestic partnership shall be considered the separate property of the recipient of the gift, unless the party making the gift specifies that the property is to be the joint property of the parties. Such specification shall be in writing and attached to this Domestic Partnership Agreement as an Attachment.

4. General Living Expenses
The day-to-day living expenses of the parties, such as normal expenses for food, clothing, and entertainment, shall be paid by the parties in such proportions as they from time to time may agree upon in light of the then available resources of each party.

5. Joint Checking Account
The parties shall establish a joint checking account from which either party may withdraw funds for the payment of household and other joint living expenses, including living expenses of the child(ren). The parties shall contribute funds to this checking account as they from time to time may agree in light of the available resources and income of each party.
The funds in this checking account, and property purchased using these funds, shall be the joint property of the parties. This checking account is for the convenience of the parties, and the amounts deposited in the account are not intended to reflect the actual cost of living of either or both of the parties.

6. The Parties’ Residence
____________________ and ______________________ are the owners of a house known as ____________________________________________ (primary residence). Said primary residence is encumbered by a mortgage and the principal balance presently outstanding is approximately $______________.
It is the intention of the parties to reside in said primary residence with their children.

The expenses of ownership of the primary residence, including without limitation utilities, homeowners insurance, real estate taxes, maintenance, and ordinary repairs, shall be paid by the parties in such proportions as they from time to time may agree upon in light of the then available resources of each party.

If, during the domestic partnership, the primary residence is sold and another residence is purchased in its place, the substitute residence shall be treated in the same manner under this Agreement as the primary residence for which it was substituted, unless the parties otherwise agree in a written instrument amending this Agreement.

The furniture, furnishings, and other household effects in the primary residence shall be the joint property of the parties, with the exception of items that were the pre-domestic partnership separate property of either party and art, antiques, or collectibles acquired as separate property of either party.

7. Other Real Estate
The parties from time to time may own real property other than the primary residence. If a party acquires such property in his/her sole name, it shall be said party’s separate property for purposes of this Agreement. If the parties acquire such property as tenants in common, the interests of each party shall be separate property interests in the proportions set forth in the deed. If the parties acquire such property as joint tenants with rights of survivorship, it shall be joint property. The rights of the parties with respect to such property shall be governed by this Agreement unless they agree to some other treatment of such property in a written instrument amending this Agreement.

8. Pensions
Any pension plans of either party, heretofore or hereafter created, shall be and shall remain separate property of such party, free from any claim of the other party, notwithstanding the domestic partnership of the parties. Any pension plans that are the separate property of a party shall not be subject to equitable distribution and shall not be considered assets to which the other party would be entitled to share in, unless, in the event of death, the other party is designated on the pension plan documents as a beneficiary.

As used herein, “pension plan” shall mean any kind of pension plan, 401(k) plan, retirement plan, profit sharing plan, employee benefit plan, or any other form of deferred compensation to which a party may be entitled because of his/her employment or work. References to a party’s pension plan shall be deemed to include all monies held in such party’s pension plan or thereafter added to or accumulated in that pension plan, and any increments, accretions, or increases in the value of such pension plan, and any other rights such party has to the pension plan or such monies.

9. Children
It is the intention of the parties to have or adopt one or more children during the domestic partnership. It is the intention of the parties that during their domestic partnership, when one partner has a child, that partner will consent to the other partner’s undertaking of any and all steps to adopt that child.

It is the intention of each party to create an irrevocable life insurance trust that will be funded by their separate funds, and that will provide for the maintenance of the surviving partner, if the domestic partnership is still in effect at the time the other partner dies. Regardless of the status of the domestic partnership, the irrevocable life insurance trust will provide for the maintenance, health, education, and welfare of the parties’ child(ren). The parties agree that each will continue to fund their own irrevocable life insurance trust until such time the life insurance policy has been paid in full or the youngest child reaches the age of twenty-five. The parties hereby agree that all indicia of life insurance shall be set forth in Schedule C, attached hereto.

10. Termination of the Domestic Partnership
The parties recognize that it is in their best interests to set forth their agreement as to their respective rights in the event of a termination of their domestic partnership by separation or dissolution of their domestic partnership.

The parties agree that the value of the primary residence and/or any other property that is owned jointly or by another entity whereby both are beneficiaries or own an equitable interest shall be determined by obtaining a current appraisal from the lending institution that possesses a mortgage on the property. If either party feels the lending institution’s appraisal is inaccurate, then a second appraisal will be obtained at the cost of the party seeking another appraisal. Both appraisals will be averaged and that average shall be the price the parties will use to determine the fair market value of the property.

The parties intend to agree upon which party will be able to remain in the primary residence, depending upon a variety of factors, the most important factor being the best interest of their child(ren). To exercise the option to purchase the primary residence one party (the Proposed Buyer) must give the other party (the Proposed Seller) written notice of her election to purchase the Proposed Seller’s interest within 90 days after termination of the domestic partnership.

Termination of the domestic partnership shall be considered as written notice defined herein. If the parties cannot agree upon which party will remain in the primary residence, the primary residence will be placed with a real estate broker at listing price of the fair market value as determined by the method set forth above.

If practicable, the closing of title shall take place on a date not more than 60 days after the fair market value of the primary residence is determined. At the closing of title, the Proposed Buyer shall pay the amount due to the Proposed Seller and the Proposed Seller shall deliver good and clear title, free from encumbrances, and any documents that may be necessary or appropriate to transfer all of his/her right, title, and interest in the primary residence to the Proposed Buyer.

If either party elects to purchase the interest of the other party in the primary residence, the party who so elects shall also simultaneously purchase the interest of the other party in the jointly owned furniture, furnishings, and other household effects of the residence for the fair market value of such interest.

If neither party exercises the aforesaid options, the primary residence shall be promptly listed for sale with a broker mutually agreeable to the parties. The parties shall jointly agree to the listing price. If the parties cannot agree, then the average of the appraisals discussed earlier in this section shall be used to determine the listing price.

If the primary residence does not sell at the listing price within a reasonable period of time, said price shall be reduced until the residence is sold. A reasonable period of time is agreed upon to be six to eight months. The parties agree that the reduction in price will begin at five percent of the listing price. The reduction will continue in increments of five percent until the primary residence is sold.

The net proceeds from the sale of the primary residence, after deducting for all related expenses in connection with the sale, shall be divided equally between the parties. Any liens and encumbrances levied against the primary residence as the result of a debt owed by either party shall be paid by that party with his/her own separate assets prior to the passing of title to the Proposed Buyer.

In the event of the termination of the domestic partnership, the parties shall have joint legal custody of any minor children of the parties. It is the expectation of the parties that the children will reside predominantly with their respective birth or legal parent[; however, the other party shall have frequent and meaningful contact/ parenting time with the child(ren)].
Each party agrees to pay reasonable amounts, in light of his/her available income and resources, for the support of any minor children of the parties, at a minimum, in an amount that is set forth in the current child support guidelines of the state in which the parties reside. The parties agree to consult and negotiate in good faith regarding the children’s education, visitation, payment of medical expenses, and other issues that may arise regarding the children in the event of the termination of the domestic partnership.

In the event of the termination of the domestic partnership any joint property acquired by the parties during the domestic partnership shall be divided equally between the parties, notwithstanding the percentage contribution each party may have made to acquire or create such property.

The parties recognize that some items of joint property, such as tangible personal property, cannot be readily divided into shares. If the parties cannot agree on the division of any such items or the fair compensation that one party should pay to the other for his/her share of such items, such items shall be sold so that the proceeds of sale may be divided equally.
Each party hereby irrevocably waives, releases, and relinquishes any and all claims or rights that he/she now or hereafter might otherwise have to or against the separate property now owned or hereafter acquired by the other party. This includes, without limitation, laws relating to equitable distribution, marital property, community property, curtesy, dower, or any other interest or right of distribution of property by reason of domestic partnership, cohabitation, union, or marriage. Each party recognizes that this waiver includes rights he/she might otherwise have or acquire in the future under the laws of the state in which the parties resided at the time the domestic partnership terminated.

As used herein, the term “termination of the domestic partnership” shall mean either party sending the other party written notice of intent to terminate the domestic partnership.

Notice shall be sent by first class mail, certified mail, or any other form of mailing by which confirmation of delivery can be ascertained. Notice shall be sent to the party’s current residence where that person normally receives mail or to the party’s last known address.

11. Death of the Parties
The parties recognize that it is in their best interests to set forth their Agreement as to their respective rights upon the death of either party during the domestic partnership.

All jointly owned property shall pass in accordance with the laws of the state in which the property is located. Title to property held jointly with rights of survivorship will pass to the survivor in accordance with state law.
Each party retains sole control over his/her separate property. Each party shall have the right to dispose of that separate property either by will or inter vivos or in accordance with the rules of intestate succession of the state in which the decedent was domiciled.

Nothing in this Agreement shall restrict the right of either party to bequeath or give property to the other party. If either party should provide that the other party shall receive property, as a bequest or gift under his/her last will and testament or otherwise, including without limitation life insurance proceeds, pension or profit sharing plan benefits, and assets held as joint tenants with rights of survivorship, such other party shall have the right to receive such property. The parties agree, however, that no promises of any kind have been made by either of them to the other with respect to any such bequest or gift.

The obligations set forth in this Article 11 shall terminate and cease to be binding in the event of the termination of the domestic partnership by separation or dissolution of their domestic partnership or annulment, except separate property shall always remain separate property.

If, upon the death of either party, an action for separation or dissolution of their domestic partnership or annulment has been commenced but a judgment has not been entered, any rights of the surviving party to share in the estate of the deceased party shall be extinguished and the surviving party shall be entitled to receive from the decedent’s estate only what the surviving party would have been entitled to pursuant to the Agreement had a judgment of separation or dissolution of their domestic partnership been entered.

12. Full Disclosure
A copy of the parties’ current net worth statement is attached hereto as Schedule B. The parties affirm that the contents of the net worth statement are accurate and true.

Each party has made independent inquiry, to his/her own satisfaction, into the complete financial circumstances of the other, and acknowledges that he/she is fully informed of the income, assets, and financial prospects of the other.
[Neither of the parties has been previously married. Neither of the parties has living children.]

13. Legal Representation
The parties acknowledge that they have retained and have been represented by separate and independent legal counsel of their own choosing in connection with the negotiation of this Agreement. _______________________ consulted with Attorney _____________________________. ____________________________ consulted with Attorney _________________________. Each has been separately and independently advised regarding this Agreement including the rights waived or otherwise released herein.

14. Notices
Any notice, demand, or other communication required or permitted under this Agreement shall be in writing and shall be delivered by hand or by courier or by certified or registered mail, return receipt requested, to a party at his/her address stipulated above or at such other address as the party may designate.

15. General Provisions
This Agreement is entire and complete and embodies all understandings and agreements between the parties. All prior understandings, agreements, conversations, communications, representations, correspondence, and other writings are merged into this instrument, which alone sets forth the understanding and agreement of the parties.

Each party acknowledges that all of the matters embodied in this Agreement, including all terms, covenants, conditions, waivers, releases, and other provisions contained herein, are fully understood by each; that this Agreement is fair, just, and reasonable; that each party is entering into this Agreement freely, voluntarily, and after due consideration of the consequences of doing so; and that this Agreement is valid and binding upon each party.

This Agreement and each provision thereof shall not be amended, modified, discharged, waived, or terminated except by a writing executed by the party sought to be bound. Failure of a party to insist upon strict performance of any provision of this Agreement shall not be construed as a waiver of any subsequent default of the same or similar nature, nor shall it affect the parties’ rights to require strict performance of any other portion of this Agreement. Any waiver by either party of any provision of this Agreement or of any right or option hereunder shall not be deemed a continuing waiver and shall not prevent such party from thereafter insisting upon the strict performance or enforcement of such provision, right, or option.

The parties agree that each of them, upon request of the other party or the legal representatives of the other party, shall execute and deliver such other and further instruments as may be necessary or appropriate to effectuate the purposes and intent of this Agreement. Each party, upon request of the other, shall execute and deliver a confirmation that this Agreement remains in full force and effect.

This Agreement and all rights and obligations of the parties hereunder shall be governed by and construed in accordance with the laws of the State of ____________. The laws of the State in which the parties reside with their child(ren) shall govern irrespective of whether either or both of the parties heretofore or hereafter reside or are domiciled in any other jurisdiction and irrespective of whether any property is located in any other jurisdiction. If any provision of this Agreement should be held to be invalid or unenforceable under the laws of any State, county, or other jurisdiction in which enforcement is sought, the remainder of this Agreement shall continue in full force and effect.

This Agreement shall be binding upon and shall inure to the benefit of the parties hereto and their respective heirs, executors, administrators, successors, and assigns.

Designation of Agent for partner form

Designation of Agent

I, ________________________, designate my partner, _________________________, to be my agent empowered with the following authority.

1. VISITATION AUTHORITY: To give notice that, if I am admitted to a medical facility of any type, a nursing home, hospice, or similar health care, skilled nursing, or custodial facility, my agent, _____________________________, shall be designated as “family” as that term is defined by the Joint Commission on Accreditation of Healthcare Organizations. JCAHO defines “family” as “The person(s) who plays a significant role in the individual’s [patient’s] life. This may include a person(s) not legally related to the individual.” (Joint Commission Resources, JCR, 2001 Hospital Accreditation Standards, p. 322).
My agent shall have priority in being admitted to visit me in such facility. My partner, as my agent, is designated as the person to be consulted by medical or health care personnel concerning my care and treatment. This is in keeping with the Health Care Power of Attorney I executed. My agent shall also have the authority to determine who will be permitted to visit me while in the facility and during any recovery at home.

This authorization supersedes any preference given to parties related to me by blood or by law or other parties desiring to visit me. These instructions shall remain in full force and effect unless and until I freely give contrary written instructions to competent medical personnel on the premises involved. My subsequent disability or incapacity shall not affect these instructions.

2. RECEIPT OF PERSONAL PROPERTY: My agent shall also have the right to receive any and all items of personal property and effects that may be recovered from or about my person by any hospital, nursing home, other health care facility, police agency, or any other person or public/private entity at the time of my illness, disability, or death. This specifically includes cash or other liquid asset(s).

3. DISPOSITION OF REMAINS/AUTOPSY AUTHORIZATION/FUNERAL ARRANGEMENTS: My agent shall have the authority to authorize an autopsy if it is deemed necessary or is required by law. In matters concerning the disposition of my remains and funeral arrangements, I provide that my agent/partner, or any other person directed to dispose my remains, shall follow my instructions for any funeral services. Any limitations on this authority are specified in this document.
My agent is to direct the disposition of my remains by the following method:
burial ______ cremation ______ . The specific instructions are found in ______________________________________________________________________________________________ .
In this regard, my agent has the authority to make all decisions necessary for my obituary notice, funeral, any mortician’s role therein, burial services, interment or cremation of my body, including, but not limited to the selection of a casket or urn, selection, care and tending of a grave site, and selection of a gravestone including the inscription thereon.

4. SPECIFIC INSTRUCTIONS CONCERNING MY AGENT’S AUTHORITY OR LIMITATIONS THEREON: My agent shall have access to all medical records and information pertaining to me and concerning treatments, procedures, treatment plans, etc. This includes the right to disclose this information to other people. I explicitly authorize any medical or health care provider to release information requested by my agent to him/her and consider my agent an authorized person to receive such information under the Health Information Portability and Accessibility Act (HIPAA).
My agent has the authority to admit or discharge me from any hospital, nursing home, residential care, assisted living or similar facility, or service entity. My agent also has the authority to hire and fire medical, social service, and other support personnel. My agent is primarily responsible for my medical and health care.

_________________ ___________________________________________
Date Principal

State of _____________
County of ___________

Before me, a Notary Public in and for said County and State, personally appeared the above named, ___________________________, who acknowledged that he/she did sign the foregoing two-page instrument, and that the same is his/her free act and deed.

In Testimony Whereof, I have hereunto set my hand and official seal at __________, __________________, this _______ day of _________, 20___.

___________________________________________
Notary Public

WILLS, PROBATE AND ELDER LAW- Adult and Community Education

WILLS, PROBATE AND ELDER LAW- Adult and Community Education
WHEN: Tuesday April 8, 2008 7 - 8:30 P.M.
You don’t have to be wealthy or near death to do some thinking about a will. Here is your opportunity to listen to an experienced attorney who will discuss how to distribute your property as you wish and avoid many rigid provisions of the state law. Topics covered by author of “Answer to questions about Probate” will include: Estate Planning for Same Sex Coupls, Wills, revocable trusts, irrevocable trusts, power of attorney, living will, long term care insurance, reverse mortgage, plus the opportunity to ask questions.
Instructor: Kenneth Vercammen, Esq. of Edison
(Co-Author- NJ Elder Law & Probate)

COMPLIMENTARY MATERIAL: Brochures on Wills, "Probate and Administration of an Estate", Power of Attorney, Living Wills, Real Estate Sales for Seniors, and Trusts.
Here is your opportunity to listen to an experienced attorney who will answer questions how to distribute your property and avoid many rigid provisions of state law. For more information on Elder law, visit the Website www.centraljerseyelderlaw.com. You can also subscribe to the free email Elder Law newsletter by visiting the website, or sending an email to Kenv@njlaws.com.

East Brunswick Adult & Community Education Program
East Brunswick HIGH SCHOOL, Cranbury Rd
Course # SPS ....... Fee: $29
Tues. 7:00–9:00 pm ........ 1 session: 4/8

$ 29.00 registration fee required by adult school for all others. Call the Adult Education Office for registration information 732- 613-6989
http://www.ebnet.org/Community_Programs/downloads/Spring_2008_Web.pdf
Please make checks payable to Adult and Community Education and mail to:
Director, East Brunswick Adult and Community Education,
EBHS, 380 Cranbury Road, East Brunswick, NJ 08816-3095.

About the Speaker: Kenneth Vercammen is an Elder Law and Litigation Attorney in Edison, NJ. He often lectures for the American Bar Association and New Jersey State Bar Association on Elder Law, personal injury, and criminal / municipal court matters. He has published 125 articles in national and New Jersey publications on legal topics. He speaks as a volunteer on Wills and Elder law to Adult Community Schools and non profit groups including Edison, Metuchen, Woodbridge, East Brunswick, North Brunswick, South Brunswick, Piscataway, Sayreville, Old Bridge, Spotswood and Perth Amboy Seniors. He has established New Jersey's most popular Elder law website on the Internet to provide information on Probate, Elder Law and Traffic matters located at www.centraljerseyelderlaw.com.

Middlesex County Bar Association 3rd Annual Awards Dinner

Middlesex County Bar Association 3rd Annual Awards Dinner
On March 19, 2008, the Middlesex County Bar Association will hold its third annual awards dinner at Sunny Palace Restaurant on Route 18 South in East Brunswick. Awards will be given to bar members in the following areas: Pro Bono; Non-Litigation; Civil Trial Practice; Criminal Trial Practice; and Municipal Court Practice.

The guest speaker will be Hon. Travis L. Francis, AJSC.
The MCBA will pay tribute to these bar members for their significant contributions to their respective practice areas.
The following awards will be given:

-Pro Bono Attorney-of-the Year Henry Gurshman
-Civil Trial Practitioner-of-the-Year John Gorman
-Criminal Trial Attorney-of-the-Year Jim Nolan & Nicole Albert
-Municipal Court Practitioner-of-the-Year Kenneth Vercammen
-Young Lawyer of the Year Kimberly Yonta Aronow
-Transactional Attorney of the Year Michael Schaff

The purpose of the Awards is to recognize attorneys practicing in Middlesex County and adjacent municipalities who devote a significant portion of their law practice to their respective practice areas and exhibit one or more of the following:

- Leadership in the potential candidate’s field of practice;
- Significant, tangible contributions to the Bar, such as participation in educational panels, Bar committees, etc, pertaining to non-litigation issues;
- Contributions to the community and/or charitable endeavors;
- A record promoting participation and involvement in the MCBA and collegiality within the Association; and
- A reputation for personal and professional integrity.

The evening will commence with a cocktail hour (cash bar) at 6:00 p.m. and dinner will be served at 7:00 p.m. The cost to attend is $35 for MCBA Young Lawyers, $40 for MCBA Members and $45 for all others, in advance.
For additional information, contact the Bar Office at (732) 828-3433, ext. 102.
More details at http://www.mcbalaw.com/cde.cfm?event=186648

Sunny Palace
1069 Route 18 South
East Brunswick, NJ 08816

General Durable Power of Attorney

Warning to Person Executing This Document
This is an important and powerful document. It creates a durable power of attorney. Before executing this document you should know these facts:

1. This document provides the person you designate as your attorney-in-fact with broad powers to dispose, sell, convey, and encumber your real and personal property.

2. These powers will exist for an indefinite period of time unless you limit their duration in this document. These powers will continue to exist even if you become disabled, incapacitated, or incompetent.

3. You have the right to revoke or terminate this durable power of attorney at any time; however, you must do so in writing.

I, (principal’s name) of (principal’s address) , the Principal, hereby create this General Power of Attorney for the purpose of enabling the Agent named below to act as my agent and attorney-in-fact on all matters at all times, either before or after my disability.

1. Designation of Agent. I hereby designate and appoint (agent’s name) of (agent’s address) to be my agent and attorney-in-fact to act in my name and stead for all purposes.

In the event that my designated agent named above shall, at any time, be unable or unwilling to serve, or continue to serve, as my agent and attorney-in-fact, I hereby designate and appoint (alternative agent’s name) of (alternative agent’s address) to be my agent and attorney-in-fact to act in my name and stead for all purposes.

2. Effective Date. This General Power of Attorney and the powers conferred herein shall be effective as of the date I execute this document as set forth below.

3. Disability or Disappearance of Principal. This General Power of Attorney shall not be affected by my disability. The powers and authority conferred to my agent _____ in this instrument shall be fully exercisable by him/her notwithstanding my subsequent disability or incapacity or any later uncertainty as to whether I am alive or dead. All acts performed by my agent pursuant to this General Power of Attorney during any period of my disability or incompetence or during any period of uncertainty as to whether I am alive or dead shall have the same effect and inure to the benefit of and bind me, my heirs, devisees, and personal representative, to the same extent as if I were alive, competent, and not disabled.

4. Nomination of Guardian of Person and Estate. In the event I become disabled and am unable to manage my own affairs, I hereby nominate _______________ as the Guardian of my person and estate. I nominate him/her as my Guardian because he/she is best suited to carry out my wishes, desires, and intentions concerning my estate. He/She is also the person who has my best interests at heart. I trust him/her completely and ask the Probate Court to honor my selection of my Guardian. I also ask that my nominee serve without bond.

In the event the Probate Court does not name my nominee as the Guardian of my person and estate, I demand that the person selected by the Court be required to post a bond to serve in the capacity of Guardian.

5. Powers of Agent. The Agent acting under this General Power of Attorney shall have the full power and authority to do and perform every act and thing to the same extent as I could do if personally present and under no disability. The Agent shall have all of the powers, rights, discretions, elections, and authority conferred by statute, the common law, or rule of court or governmental agency that are reasonably necessary for the Agent to act on my behalf for any purpose. In addition to these general powers, the Agent shall have the following specific powers:

a. The power to request, ask, demand, sue for, recover, sell, collect, forgive, receive, and hold money, debts, dues, commercial paper, checks, drafts, accounts, deposits, legacies, bequests, devises, notes, interests, stocks, bonds, certificates of deposit, annuities, pension and retirement benefits, insurance proceeds, any and all documents of title, choses in action, personal and real property, intangible and tangible property and property rights, and demands whatsoever, liquidated or unliquidated, as now are, or may become, owned by, or due, owing, payable, or belonging to me, or in which I have or may hereafter acquire an interest; to have, use, and take all lawful means and equitable and legal remedies, procedures, and writs in my name for the collection and recovery thereof, and to adjust, sell, compromise, and agree for the same; and to make, execute, and deliver for me, on my behalf and in my name, all endorsements, acceptances, releases, receipts, or other sufficient discharges for the same.

b. The power to prepare, sign, and file joint or separate income tax returns or declarations or estimated tax returns for any year or years; to prepare, sign, and file gift tax returns with respect to gifts made by me, or by the Agent on my behalf, for any year or years; to consent to any gift and to utilize any gift-splitting provision or other tax election; and to prepare, sign, and file any claim for refund of any tax. This power is in addition to and not in limitation of the tax powers granted in the next paragraph.

c. The power and authority to do, take, and perform each and every act and thing that is required, proper, or necessary to be done, in connection with executing and filing any tax return, receiving and cashing any refund checks with respect to any tax filing, and dealing with the Internal Revenue Service and any state and local tax authority concerning any gift, estate, inheritance, income, or other tax, and any audit or investigation of same. This power shall include the power to do all acts that could be authorized by a properly executed Form 2848, entitled “Power of Attorney and Declaration of Representative,” granting the broadest powers provided therein to the Agent.

d. The power to conduct, engage in, and transact any lawful matter of any nature, on my behalf or in my name, and to maintain, improve, invest, manage, insure, lease, or encumber, and in any manner deal with any real, personal, tangible, or intangible property, or any interest in them, that I now own or may later acquire, in my name and for my benefit, upon such terms and conditions as the Agent shall deem proper.

e. The power to exercise or perform any act, power, duty, right, or obligation that I now have, or may later acquire, including, without limiting the foregoing, the right to enter into a contract of sale and to sell any real, personal, tangible, or intangible property on my behalf and the right to renounce or disclaim any testamentary or nontestamentary transfer intended for me.

f. The power to make, receive, sign, endorse, acknowledge, deliver, and possess insurance policies, documents of title, bonds, debentures, checks, drafts, stocks, proxies, and warrants, relating to accounts or deposits in, or certificates of deposit, other debts and obligations, and such other instruments in writing of any kind or nature as may be necessary or proper in the exercise of the rights and powers herein granted.

g. The power to sell any and all shares of stocks, bonds, or other securities now belonging to or later acquired by me that may be issued by any association, trust, or corporation, whether private or public, and to make, execute, and deliver any assignment or assignments of any such shares of stocks, bonds, or other securities.

h. The power to conduct or participate in any business of any nature for me and in my name; execute partnership agreements and amendments thereto; incorporate, reorganize, merge, consolidate, recapitalize, sell, liquidate, or dissolve any business; elect or employ officers, directors, and agents; carry out the provisions of any agreement for the sale of any business interest or the stock therein; and exercise voting rights with respect to stock, either in person or by proxy, and exercise stock options.

i. The power to enter any safe deposit box rented by me, and to remove all or any part of the contents thereof, and to surrender or relinquish said safe-deposit box. Any institution in which any such safe-deposit box may be located shall not incur any liability to me or my estate as a result of permitting the Agent to exercise the powers herein granted.

j. The power to make outright gifts of cash or property to adults or to minors in custodial form under an applicable Gifts to Minors Act, in amounts not to exceed Eleven Thousand Dollars ($11,000.00) to each adult or minor donee in any calendar year. Permissible donees hereunder shall include my partner, any of my children or stepchildren and their descendants, or any descendant of a brother or sister of mine or of any person to whom I shall have been married, as well as any person who shall be married to any of the foregoing.

k. To make gifts to facilitate my qualifying for the receipt of government benefits for my long-term health care and nursing home care needs (e.g., old age pension and Medicaid benefits). Any gifts made pursuant to this paragraph are to be made unconditionally as determined in the sole discretion of my attorney-in-fact. Such gifts shall be irrevocable. My attorney-in-fact is authorized to make said gifts so long as my long-term care is reasonably provided for by my assets subject to this Power, or otherwise during the time period I would be disqualified from receiving long-term care and/or medical assistance under the State Medicaid program. Any gifts may be made outright or in trust and may include both real and personal property.

l. The power to convey or assign any cash or other property of which I shall be possessed to the trustee or trustees of any trust that I may have created, provided that such trust is subject to revocation by me, which power shall be exercisable hereunder by the Agent.

m. The power to purchase United States Government Bonds known as “Flower Bonds,” which may be used in payment of death taxes from my estate.

n. Subject to the provisions of Section 1 above, the power to appoint a substitute or alternate agent and attorney-in-fact, who shall have all powers and authority of the Agent.

6. Limitation of Power of Agent. Notwithstanding any other provision of this General Power of Attorney, the Agent shall have no rights or powers hereunder with respect to any act, power, duty, right, or obligation relating to any person, matter, transaction, or property held or possessed by me as a trustee, custodian, personal representative, or other fiduciary capacity. In addition, the Agent shall have no power or right to perform any of the following functions:

7. Ratification. I hereby ratify, acknowledge, and declare valid all acts performed by the Agent on my behalf prior to the effective date of this General Power of Attorney.

8. Revocation and Termination. This General Power of Attorney is revocable by me, provided that insofar as any governmental agency, bank, depository, trust company, insurance company, other corporation, transfer agent, investment banking company, or other person who shall rely upon this power, this power may be revoked only by a notice in writing executed by me and delivered to such person or institution.

This General Power of Attorney shall not be revoked or otherwise become ineffective in any way by the mere passage of time, but rather shall remain in full force and effect until revoked by me in writing.

I hereby revoke any and all general powers of attorney previously executed by me, if any, and the same shall be of no further force or effect. However, I do not intend in this General Power of Attorney to affect, modify, or terminate any special, restricted, or limited power or powers of attorney previously granted by me in connection with any banking, borrowing, or commercial transaction.

9. Construction. This General Power of Attorney is executed and delivered in the State of ______________, and the laws of the State of _______________ shall govern all questions as to its validity and as to the construction of its provisions. This instrument is to be construed and interpreted as a general durable power of attorney. The enumeration of specific powers is not intended to limit or restrict the general powers granted to the Agent in this instrument.

10. Reliance. Third parties may rely upon the representations of the Agent as to all matters related to any power granted to the Agent in this instrument, and no person who acts in reliance upon the representation of the Agent shall incur any liability to me or my estate as a result of permitting the Agent to exercise any power. Third parties may rely upon a photocopy of this executed General Power of Attorney to the same extent as if the copy were an original of this instrument. This document consists of [number of] pages of which this is the last.

IN WITNESS WHEREOF, I have executed this Durable Power of Attorney on the ______ day of _______________, 20___.

_________________________________
Principal
State of ___________________
County of _________________

____________________________________, the Principal, personally appeared before me and executed and acknowledged this Durable Power of Attorney for Finances before me this ______ day of ____________, 20_____.

_____________________________________
Notary Public







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Kenneth Vercammen's Law office represents individuals charged with criminal, drug offenses, and serious traffic violations throughout New Jersey. Our office helps people with traffic/ municipal court tickets including drivers charged with Driving While Intoxicated, Refusal and Driving While Suspended.

Kenneth Vercammen was the NJ State Bar Municipal Court Attorney of the Year and past president of the Middlesex County Municipal Prosecutor's Association.

Criminal and Motor vehicle violations can cost you. You will have to pay fines in court or receive points on your drivers license. An accumulation of too many points, or certain moving violations may require you to pay expensive surcharges to the N.J. DMV [Division of Motor Vehicles] or have your license suspended. Don't give up! The Law Office of Kenneth Vercammen can provide experienced attorney representation for criminal motor vehicle violations.

When your job or driver's license is in jeopardy or you are facing thousands of dollars in fines, DMV surcharges and car insurance increases, you need excellent legal representation. The least expensive attorney is not always the answer. Schedule an appointment if you need experienced legal representation in a traffic/municipal court matter.

Our website www.njlaws.com provides information on traffic offenses we can be retained to represent people. Our website also provides details on jail terms for traffic violations and car insurance eligibility points. Car insurance companies increase rates or drop customers based on moving violations.

Contact the Law Office of
Kenneth Vercammen & Associates, P.C.
at 732-572-0500
for an appointment.
Kenneth Vercammen & Associates
A Law Office with Experienced Attorneys for Your New Jersey Legal Needs


2053 Woodbridge Ave.
Edison NJ 08817
732-572-0500
1-800-655-2977
Personal Injury and Criminal
on Weekends 732-261-4005

Princeton Area
68 South Main St.
Cranbury, NJ 08512
By Appointment Only
Toll Free 800-655-2977
http://www.njlaws.com/General_Durable_Power_of_Attorney.htm

GOVERNOR CORZINE SIGNS LEGISLATION specifically provide that “gender identity or expression” and “national origin” are within the protected classes

GOVERNOR CORZINE SIGNS LEGISLATION specifically provide that “gender identity or expression” and “national origin” are within the protected classes
S-2975/A-4591 (Buono, Weinberg/Caraballo, Vainieri Huttle, Chivukula, McKeon) – Revises laws concerning hate crimes and bullying; establishes Commission on Bullying in Schools.
Section 1 of the bill amends the law concerning the crime of bias intimidation to specifically provide that “gender identity or expression” and “national origin” are within the protected classes set forth in the statute. Current law enumerates the protected classes of “race, color, religion, gender, handicap, sexual orientation, or ethnicity.” Although a bias crime based on gender identity or expression or national origin can be prosecuted using the protected classes currently enumerated in the law, this amendment makes clear that these classes are intended to fall within the provisions of the statute. In addition, section 1 replaces the outdated term “handicap” with the more contemporary term “disability.” This change is not intended to change substantive law. Under the provisions of this section, a person may be guilty of the crime of bias intimidation if he commits, attempts, conspires, or threatens the immediate commission of certain specified offenses with a purpose to intimidate an individual or group because of race, color, religion, gender, disability, sexual orientation, gender identity or expression, national origin, or ethnicity or knowing that the conduct would cause an individual or group to be intimidated on that basis or under circumstances in which the victim believes he was targeted on that basis. The bill further clarifies the law by specifying that it is not a defense to a prosecution for the crime of bias intimidation that the defendant was mistaken as to the race, color, religion, gender, disability, sexual orientation, gender identity or expression, national origin, or ethnicity of the victim.
Section 1 also adds a new subsection f. to N.J.S.A.2C:16-1 to provide for additional penalties for the crime of bias intimidation. Under this subsection, a court may order a person convicted of bias intimidation to: complete a class or program on sensitivity to diverse communities, or other similar training in the area of civil rights; complete a counseling program intended to reduce the tendency toward violent and antisocial behavior; or make payments or other compensation to a community-based program or local agency that provides services to victims of bias intimidation. These penalties would be in addition to any other penalties required by the State’s sentencing laws.
Section 2 of the bill amends N.J.S.A.2A:53A-21 to include a purpose to intimidate because of “gender identity or expression” or “national origin” in the existing civil cause of action for bias crime victims. In addition, the bill replaces the outdated term “handicap” used in N.J.S.A.2A:53A-21 with the more contemporary term “disability.” Under the provisions of this section of the bill, a person, acting with purpose to intimidate an individual or group because of race, color, religion, gender, disability, sexual orientation, gender identity or expression, national origin, or ethnicity, who engages in conduct that is an offense under the provisions of the New Jersey criminal code, commits a civil offense and may be liable for damages, including punitive damages.
Section 3 of the bill amends N.J.S.A.52:4B-11 to add the crime of bias intimidation to the list of crimes for which the Victims Crimes Compensation Agency may order the payment of compensation for personal injury or death. Including victims of bias intimidation specifically in N.J.S.A.52:4B-11 will enable them to be the beneficiaries of the services the Victims Crimes Compensation Agency offers.
Section 4 of the bill would require local and county police to include information about bias crimes in their quarterly reports of crime to the Attorney General. This information would then be included by the Attorney General in the annual report of crime in New Jersey submitted to the Governor and the Legislature pursuant to N.J.S.A.52:17B-5.5.
Section 5 of the bill would require the Attorney General or the Division of State Police, if the Attorney General so designates, to maintain a central repository of information submitted from county and local police concerning bias crimes. The information in the repository would be available to the public.
Section 6 would require the Police Training Commission to require all new police officers to complete two hours of training, which may include interactive training, in identifying, responding to, and reporting bias intimidation crimes. The Police Training Commission would develop or revise the course in consultation with the New Jersey Human Relations Council. The training course shall include the following topics:
• features that identify or could identify a bias intimidation crime;
• laws dealing with bias intimidation crimes
• law enforcement procedures, reporting, and documentation of bias intimidation crimes; and
• techniques and methods to handle incidents of bias intimidation crimes, including training on how to deal sensitively with victims and referring victims of bias intimidation crimes to organizations that provide assistance and compensation to victims.
Section 7 of the bill amends N.J.S.A.18A:37-15 to require each district’s bullying policy to include a requirement that the policy be posted on the district’s website and distributed annually to parents and guardians.
Section 8 of the bill would require school districts to amend their bullying policies, post bullying policies on the web, and notify students and parents that the policy is available online within 120 days of the date of enactment (60 days from the effective date of section 8 of the bill).
Section 9 of the bill would establish the Commission on Bullying in Schools. The commission shall consist of 14 members as follows:
• the Commissioner of the Department of Education, or his designee;
• the Director of the Division on Civil Rights in the Department of Law and Public Safety, or his designee;
• the Governor shall appoint eight public members: one representative of the New Jersey Education Association, one representative of the New Jersey School Boards Association, one representative of the Anti-Defamation League, one representative of the New Jersey Principals and Supervisors Association, and four public members with a background in, or special knowledge of, the legal, policy, educational, social or psychological aspects of bullying in schools;
• the President of the Senate shall appoint two public members with a background in, or special knowledge of, the legal, policy, educational, social or psychological aspects of bullying in schools; and
• the Speaker of the General Assembly shall appoint two public members with a background in, or special knowledge of, the legal, policy, educational, social or psychological aspects of bullying in schools.
The commission shall study and make recommendations regarding:
• the implementation and effectiveness of school bullying laws and regulations;
• the adequacy of legal remedies available to students who are victims of bullying and their parents and guardians;
• the adequacy of legal protections available to teachers who are in compliance with school bullying policies;
• training of teachers, school administrators, and law enforcement personnel in responding to, investigating and reporting incidents of bullying;
• funding issues related to the implementation of the State school bullying laws and regulations; and
• the implementation of a possible collaboration between the Department of Education and the Division on Civil Rights in the Department of Law and Public Safety on a Statewide initiative against school bullying.
Members shall be appointed within 30 days of enactment and serve without compensation, but may be reimbursed for necessary expenses incurred in the performance of their duties, within the limits of funds appropriated or otherwise made available to the commission for its purposes.
The commission shall choose a chairperson from among its members. Any vacancy in the membership shall be filled in the same manner as the original appointment.
The commission shall conduct a minimum of three public hearings: one in the northern portion of the State; one in the central portion of the State; and one in the southern portion of the State.
The commission shall report its findings and recommendations, along with any legislation it desires to recommend for adoption by the Legislature, to the Governor and the Legislature. The commission shall issue its final report no later than nine months after final appointment of its members and expire thereafter.
The committee amended the bill to require school districts to amend their bullying policies, post bullying policies on the web, and notify students and parents that the policy is available online within 120 days of the date of enactment (60 days from the effective date of section 8 of the bill). The committee also amended the bill to add a representative of the New Jersey Principals and Supervisors Association to the Commission on Bullying in Schools created by the bill.

Portions of a Will Format used for Same Sex Couples

Portions of a Will Format used for Same Sex Couples

Last Will and Testament
of
______________________________________


I, _____________________________, of ______________________, ______________, hereby make, publish, and declare this to be my Last Will and Testament and revoke all previous wills and codicils made by me.
Section 1. Identification of Family
1.01 My partner’s name is ____________________________. All references in this will to my partner, whether or not specifically named, shall mean only my partner, ______________________.
1.02 I have (no) living children or issue. [Specify names of children and whether they are minors or adults. If minors, will must also include a Guardian of Person and Estate clause in conformance with state law. Include the partner’s children in the definition of children whether biological or adopted; include any children where the partner’s adoption petition has not been finalized.]
Section 2. Nomination of Executor
2.01 I hereby nominate ________________________ to serve as my Executor. Should this person be unable or unwilling at any time to serve as my Executor, I nominate ___________________ of ________________________, ________________, to serve as my Alternate Executor.
2.02 I direct that my Executor, and any successor thereto, be permitted to serve without bond in any jurisdiction.
Section 3. Disposition of Tangible Personal Property
3.01 I give, devise, and bequeath my tangible personal property to my partner, ___________________________. My Executor may, in his/her sole discretion, sell any of the property that, in his/her opinion, is not suitable for distribution, and the proceeds thereof shall become a part of my residuary estate. If the devisee named in this section does not survive me, I direct that the said property be disposed of or distributed with the residue of my estate.
Section 4. Residuary Devise
4.01 The balance of my residuary estate shall consist of all property or money owned by me at the time of my death and not otherwise effectively disposed of in this will, including all insurance proceeds or other death benefits that are payable to my estate but excluding any property over which I may have a power of appointment, less all valid claims asserted against my estate and all expenses incurred in administering my estate, including expenses of administering nonprobate assets.
4.02 I give, devise, and bequeath the balance of my residuary estate to my partner, ________________________________, if he/she survives me.
4.03 If my partner predeceases or fails to survive me I give, devise, and bequeath the balance of my residuary estate to _________________________.
4.04 I am leaving my estate to my partner, ________________, because he/she is my life partner. I am not making these provisions out of any disrespect or lack of affection or love for my family. It is my intention that my partner, _____________________, inherit my estate. [Also, see proposed clause in Chapter 4.]
Section 5. Specific Provision Regarding My Pet(s)
5.01 If my partner, _______________________, predeceases or fails to survive me, I bequeath any pets I may own at the time of my death to ____________________. He/She is willing and able to maintain my pets in a comfortable setting with a standard of care similar to that which I had provided for them. I bequeath to ____________________, for accepting my pets under the foregoing sentence, the sum of $500 per pet. This bequest is made with the intention that such amount shall defray the costs of providing care to my pets, but without any restriction or obligation to account to any person for the use of such funds.
5.02 If __________________________ is unable to accept and care for my pets, I authorize and request my Executor to select an appropriate person who is willing and able to do so and to maintain my pets in a comfortable setting with a standard of care similar to that which I had provided for them. I bequeath to the person accepting my pets under the foregoing sentence the sum of $500 per pet. This bequest is made with the intention that such amount shall defray the costs of providing care to my pets, but without any restriction or obligation to account to any person for the use of such funds.
Section 6. Powers of Executor
6.01 My Executor, and any successor thereto, shall have all of the powers granted to Executors and fiduciaries under the probate code and other applicable laws of the state of _______, including the power to execute any joint or individual tax return on my behalf or on behalf of my estate.
6.02 My Executor shall be entitled to reasonable compensation for services actually performed and to reimbursement of expenses properly incurred.
a. My Executor shall have, in addition to any other powers, the power to invest, reinvest, sell, mortgage, lease, or otherwise transfer or dispose of any part or all of my estate, without the necessity of obtaining prior or subsequent court approval;
b. To make repairs or improvements to my property as may be deemed necessary to preserve or enhance the value of my estate;
c. To borrow funds for use in estate administration if there are insufficient liquid assets in my estate;
d. To employ persons, including attorneys, investment advisors, or other agents for assistance or advice, or not to employ such persons, as my Executor deems appropriate;
e. To compromise and settle any claims against or in favor of my estate on such terms and conditions as my Executor deems best;
f. To make determinations as to the allocation of receipts and the apportionment of expenditures between income and principal. My Executor shall not be required to follow any provision of law regarding such determinations, including [relevant chapter of state code].
6.03 My Executor may make distributions either in cash or in kind. Distributions in kind may be made at the discretion of my Executor. My Executor may make any distributions under this will either (1) directly to the beneficiary, (2) in any form allowed by applicable state law for gifts or transfers to minors or persons under disability, (3) to the beneficiary’s guardian, conservator, or caregiver for the benefit of the beneficiary, or (4) by direct payment of the beneficiary’s expenses.
Section 7. Construction and Definitions
The following rules and definitions shall apply in the construction of this instrument and in the administration of my estate:
7.01 Any reference to my “Executor” in whatever form refers to the person, persons, or institution then acting as the personal representative of my estate.
7.02 If any devisee or other beneficiary under this will dies within 30 days after my death or under such circumstances where there is insufficient evidence in the judgment of my Executor to determine whether such person has died within 30 days after my death, the devisee or beneficiary shall be deemed to have failed to survive me.
7.03 The laws of the state of _______ shall govern all questions as to the validity and construction of this.
7.04 The term “estate and death taxes” shall mean all estate, inheritance, transfer, succession, or other taxes or duties payable by reason of my death, including interest and penalties thereon.
Section 8. Payment of Taxes and Expenses
8.01 I direct my Executor to pay the expenses of administering my estate, the expenses created by reason of my death, and all estate and death taxes payable with respect to property includable in my gross estate or taxable by reason of my death, whether or not such property is part of my probate estate and whether or not such taxes are payable by my estate or by the recipient of any such property. Such taxes and expenses should be paid out of my residuary estate without apportionment.
[Optional Clause]
8.02 I direct my Executor to pay only those expenses dealing with my funeral and interment that conform to my expressed wishes. If anyone interferes with my expressed wishes concerning my funeral, memorial service, or interment, and fails to abide by those expressed wishes, that person or persons shall be wholly responsible for any and all expenses. I ask that the Court and all concerned persons in this regard honor my expressed wishes, even if those wishes run counter to those of my immediate family.

Will Format

Portions of a Will used for certain Same sex couples

Last Will and Testament
of
______________________________________


I, _____________________________, of ______________________, ______________, hereby make, publish, and declare this to be my Last Will and Testament and revoke all previous wills and codicils made by me.
Section 1. Identification of Family
1.01 My partner’s name is ____________________________. All references in this will to my partner, whether or not specifically named, shall mean only my partner, ______________________.
1.02 I have (no) living children or issue. [Specify names of children and whether they are minors or adults. If minors, will must also include a Guardian of Person and Estate clause in conformance with state law. Include the partner’s children in the definition of children whether biological or adopted; include any children where the partner’s adoption petition has not been finalized.]
Section 2. Nomination of Executor
2.01 I hereby nominate ________________________ to serve as my Executor. Should this person be unable or unwilling at any time to serve as my Executor, I nominate ___________________ of ________________________, ________________, to serve as my Alternate Executor.
2.02 I direct that my Executor, and any successor thereto, be permitted to serve without bond in any jurisdiction.
Section 3. Disposition of Tangible Personal Property
3.01 I give, devise, and bequeath my tangible personal property to my partner, ___________________________. My Executor may, in his/her sole discretion, sell any of the property that, in his/her opinion, is not suitable for distribution, and the proceeds thereof shall become a part of my residuary estate. If the devisee named in this section does not survive me, I direct that the said property be disposed of or distributed with the residue of my estate.
Section 4. Residuary Devise
4.01 The balance of my residuary estate shall consist of all property or money owned by me at the time of my death and not otherwise effectively disposed of in this will, including all insurance proceeds or other death benefits that are payable to my estate but excluding any property over which I may have a power of appointment, less all valid claims asserted against my estate and all expenses incurred in administering my estate, including expenses of administering nonprobate assets.
4.02 I give, devise, and bequeath the balance of my residuary estate to my partner, ________________________________, if he/she survives me.
4.03 If my partner predeceases or fails to survive me I give, devise, and bequeath the balance of my residuary estate to _________________________.
4.04 I am leaving my estate to my partner, ________________, because he/she is my life partner. I am not making these provisions out of any disrespect or lack of affection or love for my family. It is my intention that my partner, _____________________, inherit my estate. [Also, see proposed clause in Chapter 4.]
Section 5. Specific Provision Regarding My Pet(s)
5.01 If my partner, _______________________, predeceases or fails to survive me, I bequeath any pets I may own at the time of my death to ____________________. He/She is willing and able to maintain my pets in a comfortable setting with a standard of care similar to that which I had provided for them. I bequeath to ____________________, for accepting my pets under the foregoing sentence, the sum of $500 per pet. This bequest is made with the intention that such amount shall defray the costs of providing care to my pets, but without any restriction or obligation to account to any person for the use of such funds.
5.02 If __________________________ is unable to accept and care for my pets, I authorize and request my Executor to select an appropriate person who is willing and able to do so and to maintain my pets in a comfortable setting with a standard of care similar to that which I had provided for them. I bequeath to the person accepting my pets under the foregoing sentence the sum of $500 per pet. This bequest is made with the intention that such amount shall defray the costs of providing care to my pets, but without any restriction or obligation to account to any person for the use of such funds.
Section 6. Powers of Executor
6.01 My Executor, and any successor thereto, shall have all of the powers granted to Executors and fiduciaries under the probate code and other applicable laws of the state of _______, including the power to execute any joint or individual tax return on my behalf or on behalf of my estate.
6.02 My Executor shall be entitled to reasonable compensation for services actually performed and to reimbursement of expenses properly incurred.
a. My Executor shall have, in addition to any other powers, the power to invest, reinvest, sell, mortgage, lease, or otherwise transfer or dispose of any part or all of my estate, without the necessity of obtaining prior or subsequent court approval;
b. To make repairs or improvements to my property as may be deemed necessary to preserve or enhance the value of my estate;
c. To borrow funds for use in estate administration if there are insufficient liquid assets in my estate;
d. To employ persons, including attorneys, investment advisors, or other agents for assistance or advice, or not to employ such persons, as my Executor deems appropriate;
e. To compromise and settle any claims against or in favor of my estate on such terms and conditions as my Executor deems best;
f. To make determinations as to the allocation of receipts and the apportionment of expenditures between income and principal. My Executor shall not be required to follow any provision of law regarding such determinations, including [relevant chapter of state code].
6.03 My Executor may make distributions either in cash or in kind. Distributions in kind may be made at the discretion of my Executor. My Executor may make any distributions under this will either (1) directly to the beneficiary, (2) in any form allowed by applicable state law for gifts or transfers to minors or persons under disability, (3) to the beneficiary’s guardian, conservator, or caregiver for the benefit of the beneficiary, or (4) by direct payment of the beneficiary’s expenses.
more details at http://www.njlaws.com/Will_Format.htm

Confidential Will Questionnaire for Same Sex couples

Confidential Will Questionnaire for Same Sex couples

Please answer the following questions. Your answers provide a basis for discussing your specific estate plan needs and intentions. The answers will be used to draft your documents. Please answer the questions as completely as possible. If certain questions do not apply to you, please mark them as “N/A.” All information supplied is strictly confidential and necessary to provide you with proper advice. We will discuss any questions you have about the requested information when we meet.

1. Your legal name: ____________________________________________________
2. Partner’s legal name: _________________________________________________
3. Do you currently have a will? [ ] Yes (Please have it available) [ ] No
4. Home address: ______________________________________________________
Telephone number: ______________________________________
5. Date of birth: _______________________________________
Place of birth: _______________________________________
Citizenship:_______________________________________
6. Have you been married? [ ] Yes [ ] No
If “Yes” did marriage end in [ ] death or [ ] divorce?
Year marriage ended: _____________
If there was a divorce, please have a copy of the divorce decree available.
7. Do you have a domestic partnership agreement in effect? [ ] Yes [ ] No
If “Yes” please have a copy available for review.
8. Do you have any children? [ ] Yes [ ] No
(Skip to Question 9 if you have no children)
a. Do any of your children have special needs or are any handicapped? [ ] Yes [ ] No
b. Who has physical custody of the children? ____________________________
c. Please list all of your children, including adopted children. Include names, city, state, and ages.

Name City, State DOB
_____________________________ ___________________________ _______
_____________________________ ___________________________ _______
_____________________________ ___________________________ _______

d. Please identify any children who may have predeceased you: ________________________________________________________________________
________________________________
(Use other side if additional space is needed)
Specific Bequests of Property to Specific Persons
In many situations a person tells family members how (s)he wants the personal property divided. Generally, these items are not specifically mentioned in the will. This leaves you free to create a separate list that you may change whenever you like without having to rewrite your will. You can use the will to make a specific bequest if you are concerned your wishes will not be honored. A specific bequest may also be appropriate if you intend to leave an item to a nonfamily member.

9. Please indicate the specific item(s) you want distributed and the name of the person(s) to whom you are leaving the item(s). ___________________________
___________________________________________________________________
___________________________________________________________________
(Use other side if additional space is needed)
10. PETS. If you have pets you may want to consider what happens to them after your death. You may want to provide that a specific individual cares for your pets. In that situation, you may want to provide a specific monetary bequest to that person for the care of the pet. __________________________________
___________________________________________________________________
___________________________________________________________________
Beneficiaries of Your Estate
Please think about who you want to name to inherit your estate. You must also consider who will inherit the balance of your property (after the executor distributes the specific bequests, if any). Example: Do you want everything to go to your partner? If you have children, do you want to provide for them? Grandchildren? Other family members? Do you want everyone to receive equal shares?

11. Name the person(s) to whom you want to leave your estate:
Name: ____________________________________________
Relationship: ______________________________________
City/State: ________________________________________
Name: ____________________________________________
Relationship: ______________________________________
City/State: ________________________________________
(Use other side if additional space is needed)
12. Name the person(s) you wish to be the alternate beneficiary of your estate:
Name: ____________________________________________
Relationship: ______________________________________
City/State: ________________________________________
Name: ____________________________________________
Relationship: ______________________________________
City/State: ________________________________________
Name: ___________________________________________
Relationship: ______________________________________
City/State: ________________________________________
(Use other side if additional space is needed)
13. GUARDIANSHIP OF MINOR CHILDREN. If you have children under the age of 18 you need to consider naming a guardian. Natural parents have priority in these matters. You can name someone to be the guardian of the person and of the estate. If you do not name a guardian, and there is no other natural parent, the probate court will appoint one for any minor child(ren).

a. First choice for guardian:

Name: ____________________________________________
Relationship: ______________________________________
City/State: _________________________________________

b. Alternate choice for guardian:

Name: ____________________________________________
Relationship: ______________________________________
City/State: _________________________________________

14. EXECUTOR. Every will needs an individual to act as the executor. This is the person responsible for collecting all the property at the time of death and paying all legal debts, taxes, and expenses out of the property collected. The executor is also responsible for distributing the remaining property to the people named in your will. The executor can be anyone over the age of eighteen or it can be an institution. It is advisable to name an alternate executor in case the first person is unable or unwilling to accept the responsibility. Your executor will be compensated from the estate assets according to a schedule set by [your state] law. The executor may choose to waive the fee.

a. First choice for executor:

Name: ____________________________________________
Relationship: ______________________________________
City/State: ________________________________________

b. Alternate choice for executor:

Name: ____________________________________________
Relationship: ______________________________________
City/State: _________________________________________

15. WILL CONTEST. Consider whether any family member is apt to file a will contest. If you think that may happen, you may want to include a provision to deter people from filing a will contest. You may provide that anyone contesting the will receives nothing from the estate. Generally, you will need to leave a specific bequest sufficient to make an heir think twice before contesting your will.
16. TAX ISSUES. In order to determine if tax planning is required for your estate it is important to estimate the overall value of your accumulated property. This includes life insurance and all property listed in your name. The 2004 exemption for federal estate tax is $1.5 million. If your total estate is over $1 million more extensive estate planning may be required. We will discuss the alternatives at the interview.
Estimated value of your total assets at present: (Check one)
a. [ ] Under $1 million
b. [ ] Over $1 million
17. Do you want to sign a durable power of attorney for finances? [ ] Yes [ ] No
a. Whom do you want to name as your attorney-in-fact (the person to whom you are giving the authority to act on your behalf)?

Name: ____________________________________________________________
Address: __________________________________________________________
Telephone number: _________________________________________________
Relationship: ______________________________________________________

b. Alternate Attorney-in-fact:

Name: ____________________________________________________________
Address: ___________________________________________________________
Telephone number: _________________________________________________
Relationship: _______________________________________________________

18. Do you want to sign a health care power of attorney and living will? [ ] Yes [ ] No
a. First choice (the person designated to make health care decisions for you):

Name: ____________________________________________________________
Address: ___________________________________________________________
Telephone number: _________________________________________________
Relationship: _______________________________________________________

b. Alternate choice:

Name: ____________________________________________________________
Address: ___________________________________________________________
Telephone number: _________________________________________________
Relationship: _______________________________________________________

19. Do you want to execute a designation of agent? This document allows you to name someone to make decisions concerning who will visit you in a health care facility (including nursing home and hospice), disposition of personal effects, disposition of remains, and funeral arrangements. While these documents have not been tested in court, it does give you the opportunity to make your intentions known. [ ] Yes [ ] No
Assets
Generally, a will does not list each and every item of property that you want to convey following your death. However, it is important to list the form of ownership and the approximate value of your property. If you are unsure as to the form of ownership you can ask your insurance agent or your mortgage holder. If you are still uncertain please have the documents available and we will review them together. It is important that you complete the answers concerning the following assets as best you can.
20. a. REAL PROPERTY (e.g., residence, vacant land, rental property, vacation home). Please have your deeds available for review.

(i) Location: _______________________________________________________
Market value and mortgage balance: ___________________________________
Exact way owner(s) are named on deed: ________________________________
__________________________________________________________________
(ii) Location: _______________________________________________________
Market value and mortgage balance: ___________________________________
Exact way owner(s) are named on deed: ________________________________
__________________________________________________________________
(Use other side if additional space is needed)

b. BANK ACCOUNTS (Indicate whether checking, savings, brokerage account, or CDs)

Name/location of financial institution:__________________________________
Account balance: _____________________
Name of account holder (specify if joint or payable on death): _____________
Name/location of financial institution: _________________________________
Account balance: _____________________
Name of account holder (specify if joint or payable on death): _____________
Name/location of financial institution: _________________________________
Account balance: _____________________
Name of account holder (specify if joint or payable on death): _____________
Name/location of financial institution:__________________________________
Account balance: _____________________
Name of account holder (specify if joint or payable on death): _____________
(Use other side if additional space is needed)

c. IRAs, RETIREMENT PLANS (including 401k accounts)

Name/location of financial institution: _________________________________
Account balance: _____________________
Name of account holder: _____________________________________________
Name of beneficiary: ________________________________________________
Name/location of financial institution: _________________________________
Account balance: _____________________
Name of account holder: ____________________________________________
Name of beneficiary: ________________________________________________
Name/location of financial institution: _________________________________
Account balance: _____________________
Name of account holder: _____________________________________________
Name of beneficiary: ________________________________________________
Name/location of financial institution:__________________________________
Account balance: _________________________________
Name of account holder: _____________________________________________
Name of beneficiary: ________________________________________________
(Use other side if additional space is needed)

d. STOCKS, BONDS, MUTUAL FUNDS, INCLUDING U.S. SAVINGS BONDS
Name(s) of stocks/bonds/funds: _______________________________________
How holdings are held: ______________________________________________
Approximate value: _________________________________________________
Name(s) of stocks/bonds/funds: _______________________________________
How holdings are held: ______________________________________________
Approximate value: _________________________________________________
Name(s) of stocks/bonds/funds: _______________________________________
How holdings are held: ______________________________________________
Approximate value: _________________________________________________
(Use other side if additional space is needed)

e. TITLED VEHICLES; list all cars, trucks, boats, and motorcycles:

Year/make/model: __________________________________________________
Titled owner: ______________________________________________________
Approximate value: _________________________________________________
Year/make/model: __________________________________________________
Titled owner: ______________________________________________________
Approximate value: _________________________________________________
(Use other side if additional space is needed)

f. OTHER IMPORTANT ASSETS (e.g., stamp/coin/other collections, business interests, partnerships, lottery winnings):
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
(Use other side if additional space is needed)

g. LIFE INSURANCE POLICIES

Name on policy: ____________________________________________________
Face value: ________________________________________________________
Beneficiary: ________________________________________________________
Name on policy: ____________________________________________________
Face value: ________________________________________________________
Beneficiary: ________________________________________________________
(Use other side if additional space is needed)

Please note any additional questions you want to discuss during the interview.