Decedent's InformationFull Legal NameDate of Birth Date Format: MM slash DD slash YYYY Date of Death Date Format: MM slash DD slash YYYY Place of DeathName of SpouseDid Spouse predecease the departed? Yes No Name of all childrenLast Known Mailing AddressLast Known Physical Address Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Did the decedent have a will? Yes No Your InformationFull Legal NameMailing AddressPhysical Address Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Home Phone NumberCell Phone NumberWork Phone NumberEmail Referral source, if applicableDISCLAIMER: By providing the above information to Andrew Hoffman Law PC, LLO, please know that this does not alone create an Attorney-Client relationship and such submission does not obligate you to the payment of any attorney’s fees. By submitting this information, you are acknowledging that you are interested in Andrew Hoffman Law PC, LLO contacting you for a follow-up visit and or conference to discuss your case. EmailThis field is for validation purposes and should be left unchanged.