Test Page MDO Form

Probate Data Integration Form

Basic Information on the Deceased
Information about the Personal Representative
People who May have a right to the Deceased’s Property
Known Property of the Estate

Basic Information of the Deceased

First Name

Last Name

Residence of Deceased

Address Line 1

Address Line 2

optional

City

State

Zip Code

Mailing Address of Deceased

Address Line 1

Address Line 2

optional

City

State

Zip Code

Date of Passing

Age of Deceased

County of Passing

Did the deceased have a will?

Yes

No

Information about the Personal Representative

First Name

Last Name

Phone/Mobile

Email

Your Address

Address Line 1

Address Line 2

optional

City

State

Zip Code

Are you (check any that apply):

Incapacitated?

Financially Incapable?

Under the age of 18?

An attorney who has been suspended or disbarred?

An attorney who has resigned from the practice of law?

A licensed funeral service practitioner?

People who May have a right to the Deceased’s Property

How many heirs (people with a right to receive property under the Will) do you believe there are?

Name of Heir	Relation of Heir	Address

Other than these known heirs, are you aware of... (check all that apply):

Anyone else who may claim a right to any of the deceased’s property?

Anyone who claims the will is not accurate, in whole or in part?

Anyone who claims a different Will exists?

Anyone who believes the decedent promised to name them in the Will or to revoke this Will?

MICHAEL D. O'BRIEN & ASSOCIATES, P.C.
SW Portland

Address

12909 SW 68th Parkway, #160
Portland, OR 97223

Phone

(503) 852-9267

MICHAEL D. O'BRIEN & ASSOCIATES, P.C.
Clackamas

Address

8800 SE Sunnyside Rd Suite 211-S
Clackamas, OR 97015

Phone

(503) 683-8747

MICHAEL D. O'BRIEN & ASSOCIATES, P.C.
Bend

Address

78 NW Kearney Ave. Suite 100
Bend, OR 97703

Phone

(541) 283-1266

Test Page MDO Form

Stop Garnishment and Repossession! Contact Our Portland Bankruptcy Lawyers Today!

(503) 786-3800

Filing Bankruptcy? Facing Debt Problems? Our Oregon Attorneys are here to help!

MICHAEL D. O'BRIEN & ASSOCIATES, P.C.
SW Portland

MICHAEL D. O'BRIEN & ASSOCIATES, P.C.
Clackamas

MICHAEL D. O'BRIEN & ASSOCIATES, P.C.
Bend

Thank you for your interest
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Test Page MDO Form

Stop Garnishment and Repossession! Contact Our Portland Bankruptcy Lawyers Today!

(503) 786-3800

Filing Bankruptcy? Facing Debt Problems? Our Oregon Attorneys are here to help!

MICHAEL D. O'BRIEN & ASSOCIATES, P.C.SW Portland

MICHAEL D. O'BRIEN & ASSOCIATES, P.C.Clackamas

MICHAEL D. O'BRIEN & ASSOCIATES, P.C.Bend

MICHAEL D. O'BRIEN & ASSOCIATES, P.C.
SW Portland

MICHAEL D. O'BRIEN & ASSOCIATES, P.C.
Clackamas

MICHAEL D. O'BRIEN & ASSOCIATES, P.C.
Bend