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					The Winstone Group,
Tokyo-New York City

            Estate Planning Preparation Questionnaire

Questionnaire for Client for Developing an Estate Plan.

General Client Information
Please provide the following information regarding you and your

[client name]
[date of birth ]
Are you a U.S. Citizen?         Yes         No
      If you answered “No,” of what country are you a citizen?

Do you have any health problems?            Yes              No
     If you answered “Yes,” please explain: [explanation]

[home address]
[home phone]
[home fax]
[business address]
[business phone]
[business fax]
Page Two: Estate Planning Preparation.

Are you married?           Yes          No
Do you have a domestic partner?         Yes        No
      If you answered “Yes” to either of these questions, please fill
out the following:

[Spouse’s name]
[Date of Birth]

Is your spouse a U.S. Citizen?        Yes         No
      If you answered “No,” of what country is your spouse a
citizen? [country]

Does your spouse have any health problems?         Yes         No
     If you answered “Yes,” please list all prior marriages: [list]

Please provide the following information regarding your children:

             Child of both you and your spouse
             Your child only
             Your spouse’s child only
[address] (if not the same as yours)
[date of birth]
[social security number]

Is this child your dependent?                       Yes         No

Does this child have any health problems?        Yes           No
     If you answered “Yes,” please explain: [explanation]
Page Three: Estate Planning Preparation.

Part One. Japanese Tax Exposure.
      A. Japanese Tax Return of 2003 Heisei 15. Global
      B. Japanese Income Source: 2003
      C. Expected Income Sources for 2004 and beyond.

Part Two. Comparative Analysis of Financial Situation 2003 vs.

Part Three. Investment Goals, Objectives, and Needs.
      A. Investment Strategies
            Please list your five most important financial goals in
      order of importance. (Examples include purchasing a home
      and providing for retirement). [List]:

       Please rate the importance of the following investing

                              Mildly       Very         Most
                              Important    Important    Important
Return on Principal
Safety of Principal
Page Four: Estate Planning Preparation

Yes    No   Questions.
            Are there any investments you would rule out? If
so, please explain: [explanation]

           Is there any investment you would prefer over
others? If so, please explain: [explanation]

          Do you want to avoid investment risk altogether?
          If not, please explain your attitude toward
investment risk: [explanation]

           Are any of your assets earmarked for a specific use
at this point? If so, please explain: [explanation]

Why have you chosen the current investments in your
portfolio? [explanation]

How do you arrive at investment decisions? explanation]

B.     Income Needs
Yes    No   Questions.
            Do you or any individual in your family have a
            disability or likely to become disabled?
            -How much income do you need for disability

              -What are the sources of income to meet your
              disability needs?
Page Five: Estate Planning Preparation

Yes    No
              -What provisions do you want to apply in your
              estate plan in case of disability? (Examples
              include powers of attorneys, persons to be taken
              care of, living wills.)

             Do you expect to provide the cost of higher
             education to anyone? Please explain:
             -What do you expect that cost to be?
             -What steps have you taken to cover these costs?
             -What steps would you like to take to cover these

Yes    No Questions
            Do you expect to retire in the near future?
             Specifically, when do you expect to retire?
             -Where do you plan to retire?
             -Will your spouse retire at this time as well?
             -What specific activities do you want to do in
             -What amount of income do you need to do the
             things you want to do?
             -What will be your income sources for these
Page Six: Estate Planning Preparation

Part Four. Assets
Please provide a description of the following, including the
approximate fair market value of the accounts. Also, please
indicate whether the item is jointly owned property (J), such
as joint tenancy and tenants in common, your separate
property (Y), or your spouse’s separate property (S).

                                        Type   Fair Market Value

 A. Investments:

Cash/ Cash Equivalents:
Money market instruments:
Annuities and Fixed-Income Securities:
Other Investments:
- Stocks
- Bonds
- Mutual Funds
- Options, commodities and collectibles
- Notes receivables
- Foreign assets
- Royalties, mineral interests, and other investments
Safe deposit assets
Household contents, (aggregate value)
Jewelry, guns, and collections
Retirement plans.
Page Seven: Estate Planning Preparation

B. Business Interests:

[Name of Business]
[Type of Entity]
[Nature of Business]
[Location of Business]
[Extent of Interest]
[Other owners, if any]

Is there a buy-sell agreement?     Yes                No
[Estimated fair market value of business]
[Estimated fair market value of interest]

C. Real Estate Assets:
[Type of Property e.g., residential, commercial, vacation home]
[Gross Fair Market Value]
[Liabilities to which the property is subject]
[Annual gross income from property]
[Annual net income from property]

D. Liabilities. Please provide information relative to each
   liability listed below.

       1. Tax Liabilities
            [Personal Property Taxes]
            [Real Property Taxes]
            [State Income Taxes]
            [Federal Income Taxes]
            [Foreign Income Taxes]
Page Eight: Estate Planning Preparation

      2. Business Liabilities.
      Please describe any business liabilities not reflected in
the value of the business section.

       3. Other Liabilities.
       Have you made any guaranties on any loans?
       -If so, what is the amount of the liability: [amount]
       -Please explain the terms of the guaranty: [explanation]

Do you have any consumer liabilities?        Yes          No
     -If so, what is the approximate amount of liability?
     -[List comments]

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