From Estate Planning Forms
- Use this helpful worksheet to set up an irrevocable life insurance trust.
1. Grantor Information
1.1 Grantor Name
1.2 Grantor City and State
2. Trustee Information
2.1 Trustee Name
2.2 Trustee City and State
3. Name of Trust
“________________________________ Life Insurance Trust”
4. Family Information
4.1 Name of Spouse
4.2 Names of Children
4.3 Are any of the above-named children step-children? Yes / No
4.4 Are provisions needed for after-born children? Yes / No
4.5 Are provisions needed for adopted and/or illegitimately born children? Yes / No
(See Paragraph 11)
5. Withdrawal Rights for Children
Greater of $5,000 or 5% of principal value? (Option 1) Yes / No
Amount of annual federal gift tax exclusion? (Option 2) Yes / No
6. Trust upon Grantor’s Death
(Separate Trust for Each Child)
A. Provision for educational incentive? Yes / No
(See Paragraph 8.b)
B. Provision for distribution to beneficiary’s descendants? Yes / No
(See Paragraph 8.c)
C. Provision for trustee authority to withhold? Yes / No
(See Paragraph 8.d)
D. If a child is deceased:
Deceased child’s share distributed
to such child’s estate? (Option 1) Yes / No
(See Paragraph 8.f)
or Deceased child’s share per stirpes
to lineal descendants? (Option 2) Yes / No
(See Paragraph 8.f)
7. Default Provisions (If Needed) If All Named Beneficiaries Deceased:
8. Definition of “Child” and “Descendant”
Include adopted prior to age ___________ (18, 21, etc.)
Include provision for illegitimate children (treated same, etc.)? Yes / No
9. Powers
Environmental Powers? Yes / No (See Master Will Paragraph 15)
Farm Powers? Yes / No (See Master Will Paragraph 16)
Limitation on Trustee Powers? Yes / No
10. Trustees
Name of initial trustee:
Name of first successor trustee:
Name of second successor trustee:
Corporate trustee compensation? (Option 1) Yes / No
Individual reimbursed for expenses but no compensation? (Option 2) Yes / No
Individual receives compensation? (Option 3) Yes / No
Amount of compensation: $
11. Incompetency
One physician decides? (Option 1) Yes / No
Two physicians decide and one board certified? (Option 2) Yes / No
12. No-Contest
Is No-Contest provision needed? Yes / No
